bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spatiotemporal Trends and Age-Period-Cohort Modeling of the Incidence of Type 1 Diabetes Among Children Aged &lt;15 Years in Norway 1973–1982 and 1989–2003
Authors: Aamodt Geir , Stene Lars C. , Njølstad Pål R. , Søvik Oddmund , Joner Geir ,   for the The Norwegian Childhood Diabetes Study Group
Published: March 2007

OBJECTIVE—We have investigated age-period-cohort effects and spatial and temporal trends for the incidence of type 1 diabetes among 0- to 14-year-old children in Norway.
RESEARCH DESIGN AND METHODS—We included children with the diagnosis of type 1 diabetes in Norway during 1973–1982 and 1989–2003. We studied age, calendar period, and birth cohort effects using Poisson regression, including Holford's method of parameterization, to model the dependencies between age, period, and cohort effects. To study spatiotemporal clustering of cases, we used spatial scan statistics.
RESULTS—The overall incidence rate for the study population &lt;15 years of age was 22.7 cases per 100,000 (95% CI 22.1–23.4), showing an average annual increase of 1.2% (95% CI 0.7–1.5%) during the study period. One specific area with 30% increased incidence rates was identified in the southern part of Norway during 1976–1980 (P = 0.001). Also, children born during 1964–1966 in a specific region in the southern part of Norway as well as children born during 1987–1989 in a region in northern Norway showed 2.0 and 2.6 times, respectively, higher incidence rates compared with the rest of the country (both P = 0.001).
CONCLUSIONS—The incidence of type 1 diabetes among children increased during the study period. Birth cohort effects were identified using the spatiotemporal scan statistic but not using age, period, and birth cohort modeling. Such effects, within the relatively homogenous Norwegian population, suggest the influence of nongenetic etiological factors.
High Titer of Autoantibodies to GAD Identifies a Specific Phenotype of Adult-Onset Autoimmune Diabetes
Authors: Buzzetti Raffaella , Di Pietro Sergio , Giaccari Andrea , Petrone Antonio , Locatelli Mattia , Suraci Concetta , Capizzi Marco , Arpi Maria Luisa , Bazzigaluppi Elena , Dotta Francesco , Bosi Emanuele ,   for the Non Insulin Requiring Autoimmune Diabetes (NIRAD) Study Group
Published: March 2007

OBJECTIVE—The aim of the present study was to define heterogeneity of adult-onset autoimmune diabetes based on characterization of GAD antibodies (GADAs).
RESEARCH DESIGN AND METHODS—Patients enrolled in a nationwide survey, the Non Insulin Requiring Autoimmune Diabetes (NIRAD) Study, have been screened for GADAs and IA-2 antibodies (IA-2As) and further characterized for GADA titer, antibodies to thyroid peroxidase (TPO), and HLA DRB1-DQB1 polymorphisms.
RESULTS—Of 4,250 consecutive type 2 diabetic patients, 4.5% had either GADAs and/or IA-2As. Patients with autoimmune diabetes showed a clinical phenotype significantly different from that of type 2 diabetes, including higher fasting glucose and A1C, lower BMI and uric acid, lower prevalence of metabolic syndrome and its components, and higher frequency of TPO antibodies. More interestingly, analysis of GADA titers showed a bimodal distribution that identified two subgroups of patients with high (&gt;32 GADA arbitrary units) and low (≤32 GADA arbitrary units) GADA titers. Compared with those with low GADA titers, patients with high GADA titers had more prominent traits of insulin deficiency and a profile of more severe autoimmunity resulting in higher A1C, lower BMI, a lower prevalence of metabolic syndrome and its components (P &lt; 0.02 for all), a higher prevalence of IA-2As, TPO antibodies (P &lt; 0.003 for both), and DRB1*03-DQB1*0201 (50 vs. 26.8%, P = 0.001), and a decreasing frequency of DQB1*0602 and DRB1*0403 (from type 2 to low and to high GADA titer autoimmune diabetes; P &lt; 0.001 for trend for both comparisons).
CONCLUSIONS—GADA titers identify two subgroups of patients with adult-onset autoimmune diabetes having distinct clinical, autoimmune, and genetic features.
Treatment of Osteoporotic Fractures of the Spine
Authors: Buljat Gojko , Perović Darko 
Published: March 2007

Mogućnosti Liječenja Osteoporotskih Prijeloma KralježniceOsteoporotski prijelomi kralježnice dva do tri puta su učetaliji nego prijelomi kuka, posebice u žena. Vertebralni osteoporotski kompresijski prijelomi tipično uključuju srednju i donju torakalnu kralježnicu i torakolumbalni prijelaz. Klinička slika očituje se u akutnom stanju u obliku nagle boli u leđima nakon minimalne ozljede a često i kad ozljede nema. U dijagnostici je osnovno uzeti dobru anamnezu te provesti klinički pregled pacijenta. Temelj radiološke dijagnostike je standardni RTG. Ako postoji klinička indikacija (diferencijalna dijagnostika tumora ili spondilitisa, neurološka slabost) radi se i CT i/ili MR. Pristup liječenju osteoporotskih prijeloma kralježnice je individualan i temelji se na povijesti bolesti, lokalizaciji simptoma, te korelaciji kliničkog pregleda i radiološkog nalaza. Česte su posljedice prijeloma dugotrajni bolovi, gubitak visine i deformacije kralježnice, koje znatno koreliraju sa smetnjama hoda i pokretljivosti, smanjenjem funkcije pluća, gubitkom teka i na kraju povećanom smrtnošću. Otvorena repozicija, dekompresija i fiksacija indicirana je u pacijenata s posttraumatskom stenozom i neurološkom slabošću. Moderne kirurške tehnike liječenja su vertebroplastika i kifoplastika koje znatno smanjuju bol i poboljšavaju pokretljivost pacijenata, a time i kvalitetu života.
Tumor Necrosis Factor-α Stimulates the Expression of C-C Chemokine Ligand 2 Gene in Fibroblasts from the Human Nasal Polyp through the Pathways of Mitogen-Activated Protein Kinase
Authors: Lin Sze-Kwan , Kok Sang-Heng , Shun Chia-Tung , Hong Chi-Yuan , Wang Chih-Chiang , Hsu Ming-Che , Liu Chia-Ming 
Published: March 2007

Background Recruitment of macrophages is crucial to the pathogenesis of the nasal polyp (NP) because this disease is believed to be inflammation related. Information regarding the expression of C-C chemokine ligand 2 (CCL2), an essential modulator of monocyte chemotaxis in nasal polyp fibroblasts (NPFs), remains unavailable. In this study, the effects of tumor necrosis factor (TNF)-α on CCL2 expression in NPFs and the signaling pathway involved were investigated. Methods Primary cultures of NPFs were established from NPs. The expressions of CCL2, c-Fos, and c-Jun mRNAs in NPF after TNF-α stimulation were detected by Northern blot. Western blot was used to examine the activation of mitogen-activated protein kinase (MAPK) signaling pathways. Activator protein (AP) 1/DNA interactions were evaluated by electrophoretic mobility shift assay (EMSA). Results Northern blot showed that TNF-α stimulated CCL2 gene expression in NPFs. Significant increase of B-Raf, phosphorated MAPK including mitogen-activated ERK-activate kinase (MEK)1/2, extracellular signal-related kinase 1/2, and p38 were detected by Western blot. c-Fos and c-Jun mRNAs were induced by TNF-α, and PD98059 (MEK inhibitor) and SB203580 (p38 inhibitor) abolished the up-regulation of c-Fos. EMSA revealed that TNF-α increased AP-1/DNA binding, and PD98059 and SB203580 attenuated this reaction, possibly via reducing c-Fos synthesis. PD98059 and curcumin (AP-1 inhibitor) markedly suppressed the TNF-α–induced CCL2 expression, whereas the effect of SB203580 was less noted. Conclusion TNF-α induces CCL2 transcription in NPFs. B-Raf/MEK/ERK signaling cascade and to a less extent the p38 pathway are responsible for c-Fos activation and the subsequent AP-1/DNA interaction leading to CCL2 expression.
Deposition of Aerosolized Particles in the Maxillary Sinuses before and after Endoscopic Sinus Surgery
Authors: St. Martin Michele B. , Hitzman Cory J. , Wiedmann Timothy S. , Rimell Frank L. 
Published: March 2007

Background Recent studies suggest that topical therapy is beneficial in many conditions underlying chronic sinusitis. Current literature has documented low aerosolized particle deposition efficiency into the paranasal sinuses. Mathematical modeling suggests that three factors influence the deposition efficiency: particle size, pressure gradient, and size of the sinus ostium. Ostium size is the most dominant factor. Therefore, we sought to determine if maxillary antrostomy and ethmoidectomy would increase the deposition efficiency. Methods Five cadavers underwent pre- and postoperative scintigraphy after administration of aerosolized Tc-99M. Images were obtained with a γ-camera and regions of interest (ROIs) were drawn around the maxillary sinuses. Counts per minute in the pre- and postoperative ROIs were then compared using the paired t-test. Results Results indicated a significant increase in deposition of radioactivity in the maxillary sinuses in the postoperative state (p < 0.01). Conclusion Topical therapy for chronic sinusitis may be more feasible in the postoperative population.
Cigarette Smoke Extract Induces Cytotoxicity on Human Nasal Epithelial Cells
Authors: Lan Ming-Ying , Ho Ching-Yin , Lee Te-Chang , Yang An-Hang 
Published: March 2007

Background The nasal mucosa is the first area to be exposed to a variety of inhaled toxins. Among various inhaled toxins, cigarette smoke is the most common one and is associated with several nasal and sinus disorders. Methods To evaluate the cytotoxic effects of cigarette smoke, primary human nasal epithelial cells were cultured in various concentrations of cigarette smoke extract (CSE) for various times. Cell viability was evaluated by WST-1 (4-[3-(4-iodophenyl)-2-(4-nitrophenyl)-2H-5-tetrazolio]-1,3-benzene disulfonate) assay. Morphological findings were observed under the light microscope and the electron microscope. Annexin-V stain was used for the detection of apoptosis. Results Using the WST-1 assay, CSE reduced cell viability in a time- and concentration-dependant manner. CSE-treated cells showed initial membrane blebbing followed by vesicle formation without apoptotic body formation or cell membrane rupture. Cells were stained with annexin-V but without propidium iodide under a fluorescence microscope. TUNEL (terminal deoxynucleotidyltransferase-mediated dUPT nick end labeling) stain was positive in CSE-treated cells. Conclusion CSE induces cytotoxicity on primary human nasal epithelial cells and the morphological findings closely mimic partition apoptosis.
Microarray cDNA to Identify Inflammatory Genes in Nasal Polyposis
Authors: Figueiredo Claudia R. , Santos Rodrigo P. , Silva Ismael D.C.G. , Weckx Luc L.M. 
Published: March 2007

Background The objective of this study was to investigate the spectrum of inflammatory gene expression in patients with nasal polyposis. Methods The cDNA microarray technique was used to identify gene expression in tissue samples from nasal polyps and adjacent inflammatory nasal mucosa of 21 patients with nonallergic nasal polyposis. To validate the microarray analysis, we compared the expression of five genes by reverse transcription-polymerase chain reaction (RT-PCR): tumor necrosis factor, IL-5, IL-9, fibroblast growth factor, and transforming growth factor (TGF)-β1. Results We tested 96 different inflammatory genes in our samples. Thirty-six genes exhibited differences in expression between the two tissue types. In all 36 genes the level of expression was greater in the inflammatory mucosa than the polyps. The RT-PCR confirmed the cDNA results. Conclusion We believe that the high expression of TGF-β1 in inflammatory mucosa compared with the low expression in polyps may reflect an important role in the inhibitory mechanisms of nasal polyposis.
Use of a Sprayed Fibrin Hemostatic Sealant after Laser Therapy for Hereditary Hemorrhagic Telangiectasia Epistaxis
Authors: Richmon Jeremy D. , Tian Ying , Husseman Jacob , Davidson Terence M. 
Published: March 2007

Background Hereditary hemorrhagic telangiectasia (HHT) is a relatively common autosomal dominant condition. Epistaxis is a frequent manifestation, often occurring daily and requiring iron and blood transfusions. Surgery often is bloody and difficult. The aim of this study was to evaluate the effectiveness of a sprayed fibrin, hemostatic sealant in preventing postoperative epistaxis after laser treatment of nasal mucosa in HHT. Fibrin sealant was compared with nasal packing for likelihood of postoperative epistaxis and financial impact including material costs and hospitalization fees. Methods Retrospective review was performed of 64 individual laser treatments for epistaxis in HHT patients at the University of California, San Diego, Medical Center between 2002 and 2005. Nasal packing was used in 30 procedures and fibrin sealant was used in 34 procedures. Results Six of 30 (20%) procedures using postoperative nasal packing required admission with an average hospital expense of $5914. One of 34 patients (3%) in the fibrin sealant group required hospitalization (p = 0.04). Conclusion Aerosolized fibrin sealant prevents postoperative epistaxis after nasal laser treatment in HHT patients. Compared with traditional nasal packing we found improved patient comfort and recovery with substantial cost savings.
Innate Responses to Aspergillus: Role of C1q and Pentraxin 3 in Nasal Polyposis
Authors: Baruah Paramita , Trimarchi Matteo , Dumitriu Ingrid E. , Dell'Antonio Giacomo , Doglioni Claudio , Rovere-Querini Patrizia , Bussi Mario , Manfredi Angelo A. 
Published: March 2007

Background Pentraxin 3 (PTX3) and complement component C1q are humoral factors of innate immunity, produced at sites of inflammation, and are essential in immune defense against several microbes such as Aspergillus, which is commonly implicated in nasal polyposis. Methods PTX3 and C1q were measured in nasal polyp tissue, normal nasal mucosa, and serum of patients and healthy subjects. Immunohistochemistry for the two proteins was done on normal nasal mucosa and nasal polyps. In addition, PTX3 and C1q production from mononuclear cells from patients and healthy subjects was assessed. Results Normal nasal mucosa was found to have 100-fold higher levels of PTX3 compared with serum. No measurable local increase of PTX3 was observed in polyps compared with normal mucosa. Immunohistochemistry revealed PTX3 expression in the lining of blood vessels both within normal mucosa and nasal polyps. PTX3 also was present in mononuclear cells infiltrating nasal polyps. C1q levels were higher in polyps than in normal nasal mucosa. Conclusion High levels of PTX3 are present in normal nasal mucosa, suggesting a role in the maintenance of tissue homeostasis. Elevated C1q levels in nasal polyps might be indicative of an ongoing inflammatory response in the nasal mucosa in these patients.
Comparison of Techniques for Transsphenoidal Pituitary Surgery
Authors: Neal Jeffrey G. , Patel Sunil J. , Kulbersh John S. , Osguthorpe J. David , Schlosser Rodney J. 
Published: March 2007

Background The aim of this study was to compare three different techniques for transsphenoidal pituitary surgery: (1) sublabial transseptal approach with microscopic resection, (2) transnasal transseptal approach with endoscopic resection, and (3) endoscopic approach with endoscopic resection. Methods We performed a retrospective review of 50 pituitary surgeries performed by the same neurosurgeon. Demographic, radiographic, and clinical data were collected. Results Fifteen patients underwent sublabial approach with microscopic tumor resection, 21 patients underwent the transnasal approach with endoscopic resection, and 14 patients underwent the completely endoscopic technique. There were a total of 20 complications in the sublabial group, 13 transnasal complications, and 6 endoscopic complications. Cerebrospinal fluid leak incidence was 53% in the sublabial approaches, 47% transnasal, and 28% in the endoscopic patients. Diabetes insipidus was encountered in 33% of sublabial approaches, 5% of transnasal approaches, and 7% of endoscopic approaches. Lumbar drains were required in 40% of sublabial approaches, 38% of transnasal approaches, and 7% of endoscopic approaches. Nasal packing was used in 100% of sublabial and transnasal approaches and 0% of endoscopic approaches. Mean recurrence rate and follow-up was sublabial in 6.6% (50 months), transnasal in 9.5% (11 months), and endoscopic in 0% (7 months). Average hospital stay for sublabial approaches, transnasal approaches, and endoscopic approaches was 8.3, 6.2, and 3.4 days, respectively (p < 0.05). Conclusion Transsphenoidal pituitary surgery has evolved over the past several decades, because advances in technology have been the catalyst for minimally invasive surgeries. Less invasive approaches, such as the transnasal approach with endoscopic resection of tumor and the completely endoscopic technique have less morbidity and a shorter hospital stay than traditional sublabial approaches. Continued follow-up is needed to confirm long-term benefits and similar recurrence rates.
Activity of Nasal Amphotericin B Irrigation against Fungal Organisms in Vitro
Authors: Shirazi Mobeen A. , Stankiewicz James A. , Kammeyer Pat 
Published: March 2007

Background The role of fungi in chronic rhinosinusitis has been described in recent reports. Controversy exists on the use of topical amphotericin B therapy as a treatment modality for this condition. The effect of various concentrations of amphotericin B nasal irrigation on actively growing fungi was studied in vitro. Methods Ten species of fungi commonly found in the nasal cavity were grown on growth media plates. Each fungi was exposed to 20 mL of amphotericin B nasal irrigation at concentrations of either 100, 200, or 300 μg/mL or sterile water two times daily for 6 weeks. Each plate was subcultured on a weekly basis to examine for any viable fungi. Results Fungi growth was not arrested in the 100-μg/mL amphotericin B and sterile water groups at the end of 6 weeks. Use of the 300-and 200-μg/mL amphotericin B solutions showed failure of the subcultured fungi to grow at 5 and 6 weeks, respectively. Conclusion Nasal amphotericin B irrigation is ineffective in killing fungi in vitro at a concentration of 100 μg/mL over a 6-week period. Concentrations of 200 and 300 μg/mL successfully prevented fungi growth at the conclusion of the study. The current concentration of commercially available topical amphotericin B (100 μg/mL) seems ineffective in eradicating fungi in vitro.
Relationship between Toxocara Seropositivity and Allergic Rhinitis
Authors: Yariktas Murat , Demirci Mustafa , Aynali Giray , Kaya Selcuk , Doner Fehmi 
Published: March 2007

Background Allergic rhinitis is the most common chronic disease in the upper respiratory tract, requiring better diagnostic methodology to counteract its onslaught. The purpose of this study was to investigate the association between Toxocara seropositivity and allergic rhinitis. Methods Sixty-four consecutive patients with allergic rhinitis and 61 healthy volunteers in the control group were included in this study. The diagnosis of allergic rhinitis was defined by positive epicutaneous prick test. The diagnosis of toxocariasis was established by IgG and specific IgE antibodies against Toxocara by ELISA method. All cases were examined for intestinal parasites also. The seropositive cases with Toxocara were reevaluated for symptoms and signs of toxocariasis. Results Higher toxocariasis seropositivity (ELISA IgG; 28.1%) rate was determined in the patients with allergic rhinitis and compared with the control groups (11.5%; p < 0.05). Specific IgE seropositivity (17.2%) was high for the patients with allergic rhinitis compared with the control group (3.3%; p < 0.05). Conclusion Our results show that there was a possible causal relationship between Toxocara infection and allergic rhinitis. Patients with allergic rhinitis from a region with high prevalence for this parasitic infection should be evaluated for Toxocara infection.
Patient Satisfaction Survey of Outpatient-Based Topical Local Anesthetic KTP Laser Inferior Turbinectomy: A Prospective Study
Authors: Orabi Ahmad A. , Sen Aloke , Timms Michael S. , Morar Pradeep 
Published: March 2007

Background The aim of this study was to determine patient satisfaction and feasibility of performing KTP laser inferior turbinectomy under topical anesthetic/decongestant spray. A prospective survey study was performed in the Outpatients’ Department of a District General Hospital. Methods Thirty-nine consecutive patients suffering from allergic or nonallergic vasomotor rhinitis were prospectively entered into the study. Preoperative details were gathered including current nasal obstruction score as indicated on a visual analog score (VAS). Lidocaine hydrochloride 5% w/v and phenylephrine hydrochloride 0.5% w/v was applied via topical spray to anesthetize and decongest the nose. The inferior turbinates (ITs) were reduced by parallel mucosal cuts using the KTP laser. Intraoperative details were recorded included pain experienced and bleeding. We studied the subjective clinical effectiveness and patient satisfaction. Results All patients were followed up at standard intervals by telephone over a 6-month period. At each interval, current nasal obstruction, pain, bleeding, and crusting on VAS were collected. Morbidity was determined in terms of return to work, return to hospital, or recurrence of symptoms. At the end of 6 months all patients were asked if they would have the procedure repeated again and/or recommend it to a friend. Reduction of ITs under topical anesthesia was acceptable to 83% of all patients. Eighty-seven percent of all patients felt they would recommend the procedure and mode of anesthesia to a friend. Our patients obtained the maximum subjective benefit at 6 weeks postoperatively. A significant improvement in nasal obstruction was achieved. There was subjective improvement in associated symptoms including hyposmia/anosmia, rhinorrhea, and sneezing. Only 28% of all patients required medication again to aid symptom control. Postoperative bleeding was insignificant. The return to a ward or clinic was minimal and 82% of all employed patients were back at work within a week. Conclusion Our study showed that KTP laser inferior turbinectomy is suitable to be performed in the outpatient department under topical anesthetic/decongestant spray and provides excellent relief for nasal obstruction and high patient compliance and satisfaction.
Impact of Age on Presentation of Chronic Rhinosinusitis and Outcomes of Endoscopic Sinus Surgery
Authors: Reh Douglas D. , Mace Jess , Robinson Jamie L. , Smith Timothy L. 
Published: March 2007

Background As the population ages, the mean age of patients with chronic rhinosinusitis (CRS) likely will increase as will the frequency of endoscopic sinus surgery (ESS) in the older population. The purpose of this study was to compare symptom presentation, CT scores, endoscopy scores, and quality of life (QOL) measures in patients <60 years of age as compared with younger patients. Methods A prospective cohort of 18 patients >60 years and 121 patients ≤60 years undergoing ESS for CRS were studied. Patient factors, symptom severity, and CT scores were examined preoperatively. Endoscopy and QOL scores were compared pre- and postoperatively between the two groups. Results The prevalence of allergies, polyps, asthma, aspirin sensitivity, and revision surgery was similar in each age group. There was no statistically significant difference in the visual analog scale scores of symptom severity in each age group. Older patients had scores that were similar to younger patients with regard to CT (13.11 versus 11.63; p = 0.419), preoperative endoscopy (8.22 versus 7.96; p = 0.828), postoperative endoscopy (3.06 versus 4.82; p = 0.100), and change in endoscopy (−5.17 versus −3.15; p = 0.083). Older patients had similar preoperative, postoperative, and change scores when compared with younger patients on the Rhinosinusitis Disability Index (−15.33 versus −20.63; p = 0.318) and Chronic Sinusitis Survey (14.35 versus 23.11; p = 0.126). Conclusion Older patients with CRS present with symptoms and patient factors that are comparable with younger patients and have a similar degree of improvement on endoscopy scores and QOL measures after ESS.