bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peroperative transrectal ultrasonography‐guided bladder neck dissection eases the learning of robot‐assisted laparoscopic prostatectomy
Authors: Van Der Poel Henk G. , De Blok Willem , Bex Axel , Meinhardt Willem , Horenblas Simon 
Published: June 2008

OBJECTIVETo study the role of peroperative transrectal ultrasonography (peTRUS) for the dissection of the bladder neck during robot‐assisted laparoscopic prostatectomy (RALP).PATIENTS AND METHODSIntegrated peTRUS in the da Vinci S system (Intuitive Surgical, Sunnyvale, CA, USA) was used for bladder neck identification and dissection in the initial 80 patients with clinically localized prostate cancer operated by two urologists. The clinical and pathological results were compared with the initial 80 patients who had RALP with no peTRUS. The location of positive margins was recorded.RESULTSThe operative duration, blood loss, hospital stay, catheter dependency, clinical and pathological T‐stage and Gleason sum score were no different between the groups. The prostate‐specific antigen level at time of diagnosis was slightly higher for patients in the peTRUS group. Basal surgical margins (bladder neck and basal areas of both prostate lobes) were positive for tumour in 9.1% and 2.3% of patients treated without and with peTRUS, respectively (P = 0.001). Although the use of peTRUS improved the basal margin rate in the initial 30 patients in each group, it did not in the last 30 in each group, when the urologist’s experience apparently improved. In a multivariate analysis the use of peTRUS and pathological T‐stage were the best predictors of basal margin status. Pad use at 6 months after surgery was similar for both groups.CONCLUSIONpeTRUS during RALP decreased the positive surgical margin rate at the base of the prostate during the initial experience of RALP.
Safety and efficacy of glargine compared with NPH insulin for the treatment of Type 2 diabetes: a meta‐analysis of randomized controlled trials
Authors: Bazzano L. A. , Lee L. J. , Shi L. , Reynolds K. , Jackson J. A. , Fonseca V. 
Published: June 2008

AbstractAims  We systematically analysed evidence from randomized controlled trials (RCTs) examining the safety and efficacy of neutral protamine Hagedorn (NPH) insulin and glargine in the management of adults with Type 2 diabetes.Methods   Studies were identified by searching medline (1966–March 2007), embase (1974–2007), American Diabetes Association abstract database and the Cochrane Central Register of Controlled Trials using Medical Subject Headings (MeSH) diabetes mellitus, Type 2, insulin, insulin isophane, hypoglycaemic agents and the keywords glargine and NPH. Data on study design, participants, fasting plasma glucose (FPG), glycated haemoglobin (HbA1c), body weight and hypoglycaemia were independently abstracted by two investigators using a standardized protocol.Results  Data from a total of 4385 participants in 12 RCTs were pooled using a random‐effects model. The mean net change (95% confidence interval) for FPG, HbA1c and body weight for patients treated with NPH insulin as compared with glargine was 0.21 mmol/l (−0.02 to 0.45), 0.08% (−0.04 to 0.21) and −0.33 kg (−0.61 to −0.06), respectively, with negative values favouring NPH and positive values favouring glargine. More participants experienced symptomatic and nocturnal hypoglycaemia on NPH than glargine, but there was no significant difference in confirmed or severe episodes.Conclusions  We identified no difference in glucose‐lowering between insulin glargine and NPH insulin, but less patient‐reported hypoglycaemia with glargine and slightly less weight gain with NPH in adults with Type 2 diabetes.
Treatment of chronic diabetic foot ulcers with bemiparin: a randomized, triple‐blind, placebo‐controlled, clinical trial
Authors: Rullan M. , Cerdà L. , Frontera G. , Masmiquel L. , Llobera J. 
Published: June 2008

AbstractAims To assess the efficacy and safety of bemiparin in the treatment of chronic diabetic foot ulcers.Methods A triple‐blind, parallel, randomized, placebo‐controlled trial. Patients aged > 8 years, with diabetes for at least 3 years, and with a foot ulcer persisting for > 3 months were selected from 39 Spanish centres. Bemiparin 3500 IU/day for 10 days, followed by 2500 IU/day for up to 3 months plus standard care for ulcers, was compared with placebo plus standard care for ulcers for 3 months. The primary efficacy end‐point was ulcer improvement, defined as an objective decrease in ulcer area of ≥ 50%, measured by digital photography and ImageJ software, and/or any decrease in Wagner's ulcer grade at 3 months.Results Ulcer improvement rates were 70.3% (26 of 37 patients) in the bemiparin group and 45.5% (15 of 33 patients) in the placebo group [absolute difference 24.8; 95% confidence interval (CI) 2.3, 47.3;P = 0.035] (number needed to treat 4; 95% CI 2, 43). Complete healing rates at 3 months were similar in both groups (35.1% vs. 33.3%;P = 0.874), as were the number of adverse events.Conclusions Bemiparin is more effective than placebo in the management of diabetic foot ulcers and has few side‐effects.
Prevalence and reasons for insulin refusal in Bangladeshi patients with poorly controlled Type 2 diabetes in East London
Authors: Khan H. , Lasker S. S. , Chowdhury T. A. 
Published: June 2008

AbstractAims  To determine the prevalence and reasons for refusal to commence insulin in Bangladeshi patients with Type 2 diabetes.Methods  A survey of 212 Bangladeshi patients seen in a hospital diabetes unit, with poor glycaemic control (HbA1c≥ 8.0%) on maximum oral glucose‐lowering therapy, in whom insulin was deemed necessary. Patients who refused insulin were invited to attend focus groups. Data were analysed by thematic content analysis using the constant comparative method.Results  Of 212 patients offered insulin, 122 (57.5%) commenced insulin immediately, 47 (22.1%) started insulin within 6 months and 43 (20.3%) refused to commence insulin despite repeated counselling. Thirty‐six (83.7%) of those who refused insulin agreed to participate in focus groups. Reasons for insulin refusal included: disease severity—perceptions that requirement for insulin was an indicator of a more serious stage of their condition; insulin leading to premature death—common suggestion that commencing insulin led to early death; loss of control—including fear of hypoglycaemia, weight gain, loss of independence and reliance on others to give insulin or look for signs of hypoglycaemia; lack of perception of benefits—poor perception of the benefits of improved glycaemic control on quality of life and cardiovascular risk; needle anxiety—a significant proportion of subjects conveyed concern over frequent injections.Conclusions  Insulin refusal is common in Bangladeshi subjects with Type 2 diabetes and poor glycaemic control. A number of factors contribute to this, and methods to overcome the barriers to insulin therapy need to be sought.
The Structure of Parent–Child Dyadic Synchrony in Toddlerhood and Children's Communication Competence and Self‐control
Authors: Lindsey Eric W. , Cremeens Penny R. , Colwell Malinda J. , Caldera Yvonne M. 
Published: June 2008

AbstractThe aim of the present investigation was to examine parent–child synchrony and its link to children's communicative competence and self‐control. Data were collected from 80 families with toddler age children (41 girls, 39 boys) during a laboratory assessment. Five components of parent–child dyadic synchrony were assessed during a semi‐structured parent–child play activity at 18 months. Assessments of children's communicative competence and self‐control were obtained at 36 months. Results indicated that parent–child synchrony, shared positive affect, and mutual compliance were highly intercorrelated components of dyadic synchrony. Moreover, children from highly synchronous parent–child dyads displayed more communicative competence and more self‐controlled behavior. Mother–child mutual compliance and father–child shared positive affect were particularly significant contributors to children's self control. The associations between synchrony and child developmental adjustment remained significant after controlling for individual child and parent behavior. Developmental implications and suggestions for future research are discussed.
Behavioral and Cognitive Readiness for School: Cross‐domain Associations for Children Attending Head Start
Authors: Bierman Karen L. , Torres Marcela M. , Domitrovich Celene E. , Welsh Janet A. , Gest Scott D. 
Published: June 2008

AbstractUtilizing a diverse sample of 356 four‐year‐old children attending Head Start, this study examined the degree to which behavioral aspects of school readiness, including classroom participation, prosocial behavior, and aggression control were related to direct assessments of child cognitive readiness (academic knowledge, executive function skills) at the start of the prekindergarten year. Classroom participation and prosocial behavior each accounted for unique variance in cognitive readiness. Aggressive behavior, in contrast, was not correlated with academic knowledge, and was associated with low levels of executive function skills. In multiple regressions, aggressive behavior paradoxically enhanced the prediction of child cognitive readiness. Profile analyses strengthened the conclusion that the promotion of competencies associated with classroom participation and prosocial behavior may be particularly critical to cognitive readiness in prekindergarten. Implications are discussed for developmental models of school readiness and preschool classroom practice.
Temperament and the Development of Conscience: The Moderating Role of Effortful Control
Authors: Stifter Cynthia A. , Cipriano Elizabeth , Conway Anne , Kelleher Rachael 
Published: June 2008

AbstractIn this longitudinal study we examined whether two components of effortful control, behavioral control, and executive function moderated the relation between temperament and conscience development. Temperament was assessed when participants were two years of age, and three temperament groups were formed: inhibited, exuberant, and low reactive. At 4.5 years of age, children's behavioral control and executive function were assessed. Moral behavior, emotionality during an empathy film, and false‐belief understanding were measured at 5.5 years of age as components of conscience. Results indicate that inhibited children may benefit most from higher levels of effortful control. Inhibited children with higher levels of behavioral control performed better on false‐belief understanding tasks whereas inhibited children who scored higher on executive function tests reported less emotional response to the evocative film. Finally, as a group, inhibited children exhibited more moral behavior than exuberant and low reactive children.
Effect of gender and highly active antiretroviral therapy on HIV‐related pulmonary arterial hypertension: results of the HIV–HEART Study
Authors: Reinsch N , Buhr C , Krings P , Kaelsch H , Kahlert P , Konorza T , Neumann T , Erbel R ,   on behalf of the Competence Network of Heart Failure
Published: June 2008

BackgroundIdiopathic pulmonary arterial hypertension (PAH) is a rare disease. HIV‐infected patients exhibit a considerably higher rate of development of this condition compared to the general population.MethodsThis cross‐sectional study of 802 (83.4% male; age 44.3±10.3 years) HIV‐positive patients aimed to evaluate the male‐to‐female ratio in HIV‐related PAH and to elucidate whether PAH is more likely to occur in patients receiving highly active antiretroviral therapy (HAART) than in HIV‐treatment‐naïve patients. All patients were examined by Doppler echocardiography to estimate systolic pulmonary arterial pressure (sPAP). Manifest PAH was defined as sPAP >35 mmHg at rest in combination with symptoms of dyspnoea.ResultsA total of 38 (4.7%) patients were diagnosed with elevated sPAP >35 mmHg. Fourteen (1.7%; 11 male) of these patients presented with symptoms of dyspnoea, resulting in a male‐to‐female ratio of manifest HIV‐associated PAH of 1:1.4. Patients with symptoms of dyspnoea and sPAP>35 mmHg were more likely to receive HAART (13/14 patients).ConclusionsIn HIV patients, sPAP occurs more frequently than has been reported previously; the condition is possibly associated with HAART. Furthermore, HIV‐positive females exhibit a higher prevalence of HIV‐related PAH (HIV–PAH) than HIV‐positive males.
Bacterial pneumonia in HIV‐infected patients: use of the pneumonia severity index and impact of current management on incidence, aetiology and outcome
Authors: Curran A , Falcó V , Crespo M , Martinez X , Ribera E , Villar del Saz S , Imaz A , Coma E , Ferrer A , Pahissa A 
Published: June 2008

ObjectivesDespite a recent decrease, bacterial pneumonia (BP) is still the most common admission diagnosis in HIV patients. We analyse BP incidence, characteristics and prevention measures.MethodsObservational study of all patients hospitalized for BP in a tertiary hospital in Barcelona, Spain, from January 2000 to December 2005. Demographic and HIV‐related data, BP risk factors, characteristics of BP and outcomes are analysed.ResultsOne hundred and eighty‐six BP episodes in 161 patients were included; patients were mainly male (73.7%) and intravenous drug users (73.7%). A decrease in BP incidence was seen during the study period, especially in vaccinated patients. The most commonly isolated microorganism was Streptococcus pneumoniae (31.7%), followed by Legionella pneumophila (5.9%). Legionella pneumophila was more likely in patients with undetectable viral load, higher CD4 cell counts or prior vaccination. Highly active antiretroviral therapy, cotrimoxazole prophylaxis and pneumococcal vaccination did not have a significant influence on bacteraemia rate, in‐hospital complications or BP mortality. High Pneumonia Severity Index (PSI) predicted mortality accurately [relative risk 15.2, 95% confidence interval 3.2–71.7; P=0.001]. Mortality was 9.1%, but was significantly higher in patients with CD4 counts under 200 cells/μL (P=0.022).ConclusionsA decline in BP incidence was seen during the study period. Combining CD4 cell count and PSI score could become a good strategy in deciding which patients have to be hospitalized.
RNA amplification of the HIV‐1 Pol and env regions on dried serum and plasma spots
Authors: Dachraoui R , Brand D , Brunet S , Barin F , Plantier J‐C 
Published: June 2008

BackgroundDried sample spots have molecular applications, but few data are available on conditions of HIV‐1 RNA amplification.ObjectivesTo determine the impact of (i) the sample type (plasma or serum), (ii) various storage periods, (iii) transfer at ambient temperature of the dried spots via postal mail, and (iv) two different methods of elution–extraction, to amplify partial pol and env genes with a view to both phylogenic and resistance analyses.MethodsFourteen samples (dried plasma spot and dried serum spot) from seven patients were stored at 20–25 °C for 2, 5 and 7 days. Two extraction buffers were tested on these samples, followed by reverse transcriptase‐polymerase chain reaction (RT‐PCR) on pol and env genes. Sixteen spots from eight other patients were sent by postal mail at ambient temperature between two laboratories, and were analysed at both sites.ResultsWe observed no influence of the 2–7 day storage period, whatever the sample type and viral load, but the choice of the extraction procedure is a critical step. Analysis of the mailed spots resulted in a good agreement between the two laboratories.ConclusionsThis study shows that amplification of HIV‐1 RNA on spots is possible in various conditions by different operators and using appropriate reagents. This finding could be particularly useful for large‐scale molecular and resistance epidemiological studies in resource‐rich and resource‐limited countries alike.
Social and economic hardship among people living with HIV in London
Authors: Ibrahim F , Anderson J , Bukutu C , Elford J 
Published: June 2008

ObjectivesTo examine the social and economic circumstances of people living with HIV in London.MethodsBetween June 2004 and June 2005, 1687 people living with HIV (73% response) receiving treatment and care in north‐east London National Health Service out‐patient clinics completed a confidential, self‐administered questionnaire. The questionnaire sought information on employment, income, education, residency status in the UK and housing.ResultsIn total, 1604 respondents were included in the analysis: Black African heterosexual women (n=480) and men (224); White (646) and ethnic minority (i.e. non‐White) homosexual men (112); White heterosexual men (64) and women (39); and Black Caribbean heterosexual women (26) and men (13). Black African heterosexual men and women consistently reported more difficulties than any other group in relation to employment, income, housing and residency status. Half the Black African heterosexual men (46.8%) and women (51.2%) reported insecure residency status in the UK, significantly more than any other group (P<0.001). Just under half the respondents (46.6%) were employed at the time of the survey; Black African heterosexual women (35.3%) and men (45.4%) were less likely to be employed than White (57.6%) or ethnic minority (53.7%) homosexual men (P<0.001). Forty per cent of Black African heterosexual men and women, 22.9% of ethnic minority homosexual men and 9.6% of White homosexual men did not have enough money to cover their basic needs (P<0.001).ConclusionsIn this study of people living with HIV in London, a substantial number faced social and economic hardship, particularly Black African and other ethnic minority respondents. Our findings provide further evidence that in London HIV is associated with poverty, particularly among migrant and ethnic minority populations.
Genotypic antiretroviral drug resistance testing at low viral loads in the UK
Authors: Cane PA , Kaye S , Smit E , Tilston P , Kirk S , Shepherd J , Hopkins M , Zhang H , Geretti AM 
Published: June 2008

BackgroundAntiretroviral drug resistance testing is recommended in HIV‐1 infected patients failing therapy in order to inform treatment selection. Although guidelines and test manufacturers recommend a viral load of at least 500–1000 HIV‐1 RNA copies/mL for genotypic resistance testing to be performed, prompt management of virological failure could benefit from testing at lower viral load levels.MethodsLaboratories undertaking genotypic resistance testing were asked to provide figures for the number of resistance tests undertaken at viral loads <2000 copies/mL, the success rates of such tests and the extent of resistance detected, all stratified for viral load levels.ResultsOf the replies received, most laboratories were attempting resistance testing at viral loads below the recommended guidelines, with variable success and outcomes.ConclusionsThis audit of current practice in the UK for undertaking genotypic resistance tests at viral loads <1000 copies/mL highlights the widespread use of such testing outside the British HIV Association guidelines.
Increased basal‐ganglia activation performing a non‐dystonia‐related task in focal dystonia
Authors: Obermann M. , Yaldizli O. , De Greiff A. , Konczak J. , Lachenmayer M. L. , Tumczak F. , Buhl A. R. , Putzki N. , Vollmer‐Haase J. , Gizewski E. R. , Diener H.‐C. , Maschke M. 
Published: June 2008

Background and purpose:  We tried to determine whether altered sensorimotor cortex and basal‐ganglia activation in blepharospasm (BSP) and cervical dystonia (CD) are restricted to areas directly responsible for the innervation of dystonic muscles, or whether impairment in focal dystonia reaches beyond these direct associations supporting a more global disturbance of sensory and motor control in focal dystonia.Methods:  Twenty patients with focal dystonia (11 BSP, 9 CD) and 14 healthy controls were investigated with functional magnetic resonance imaging (fMRI) performing a simple grip force forearm contraction task.Results:  BSP and CD patients and healthy controls showed similar activation in the pre‐motor, primary motor and primary sensory cortex, whilst basal‐ganglia activation was increased in BSP and CD with related activation patterns compared with controls. BSP patients had increased activation in the thalamus, caudate nucleus, putamen and lateral globus pallidus, whilst CD patients showed increased activation in the caudate nucleus, putamen and thalamus. No differences in applied grip force were detected between groups.Conclusions:  In both, BSP and CD, increased basal‐ganglia activation could be demonstrated in a task not primarily involving the dystonic musculature affected by these disorders. Comparable activation changes may also indicate a common pathway in the pathophysiology in BSP and CD.
Electrophysiological assessment of visual function in patients with non‐arteritic ischaemic optic neuropathy
Authors: Parisi V. , Gallinaro G. , Ziccardi L. , Coppola G. 
Published: June 2008

Background and purpose:  Our study aims to evaluate retinal function and neural conduction in post‐retinal visual pathways of patients with non‐arteritic ischaemic optic neuropathy (NION).Methods:  Twenty patients (mean age: 63.7 ± 5.96 year) with NION and 20 age‐similar control subjects were enrolled. Simultaneous recording of pattern electroretinograms (PERGs) and visual evoked potentials (VEPs), and Log of minimum angle resolution (MAR) visual acuity (VA) were assessed in NION patients and controls.Results:  Significantly (anova, P < 0.01) abnormal PERG and VEP responses, delayed retinocortical time (RCT, difference between VEP P100 and PERG P50 implicit times), and reduced VA were found in NION patients with respect to control subjects. The delay in RCT was not significantly (Pearson’s test, P > 0.01) correlated with the PERG impairment. The reduction in VA was significantly (Pearson’s test, P < 0.01) correlated to the increase in VEP P100 implicit time and RCT, whereas no correlations (P > 0.01) were found with PERG abnormalities.Conclusions:  Non‐arteritic ischaemic optic neuropathy patients with a reduction in VA may present two different, unrelated impairments: a dysfunction of the inner retinal layer (abnormal PERG) and abnormal post‐retinal neural conduction (abnormal VEP and RCT). The reduction in VA seems to be related to the post‐retinal impairment and seems to be independent from the retinal dysfunction.
Identification of Association of Common AGGF1 Variants with Susceptibility for Klippel‐Trenaunay Syndrome Using the Structure Association Program
Authors: Hu Y. , Li L. , Seidelmann S. B. , Timur A. A. , Shen P. H. , Driscoll D. J. , Wang Q. K. 
Published: June 2008

SummaryKlippel‐Trenaunay syndrome (KTS) is a severe congenital disorder characterized by capillary malformations, venous malformations or varicose veins, and hypertrophy of the affected tissues. The angiogenic factor gene AGGF1 was previously identified as a candidate susceptibility gene for KTS, but further genetic studies are needed to firmly establish the genetic relationship between AGGF1 and KTS. We analyzed HapMap data and identified two tagSNPs, rs13155212 and rs7704267 that capture information for all common variants in AGGF1. The two SNPs were genotyped in 173 Caucasian KTS patients and 477 Caucasian non‐KTS controls, and both significantly associated with susceptibility for KTS (P= 0.004 and 0.013, respectively). Permutation testing also showed a significant empirical P value for the association (empirical P= 0.006 and 0.015, respectively). To control for potential confounding due to population stratification, the population structure for both cases and controls was characterized by genotyping of 38 ancestry‐informative markers (AIMs) and the STRUCTURE program. The association between the AGGF1 SNPs and KTS remained significant after multivariate analysis by incorporating the inferred cluster scores as a covariate or after removal of outlier individuals identified by STRUCTURE. These results suggest that common AGGF1 variants confer risk of KTS.