bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐term functional and morphological effects of transcatheter arterial embolization of traumatic renal vascular injury
Authors: Mohsen Tarek , El‐Assmy Ahmed , El‐Diasty Tarek 
Published: October 2007

OBJECTIVETo assess the long‐term morphological and functional outcome of superselective transarterial embolization (TAE) for treating traumatic renal vascular injury.PATIENTS AND METHODSThe surgical records of 124 patients with traumatic renal vascular injury managed by TAE between 1990 and 2004 were reviewed, of whom 81 completed a long‐ term follow‐up and were included in the final analysis. Patients were followed using serum creatinine levels, grey‐scale ultrasonography, intravenous urography (IVU) and radioisotopic renography using 99mTc‐mercapto‐acetyl triglycine (MAG3) and 99mTc‐dimercaptosuccinic acid (DMSA).RESULTSEmbolization resulted in the cessation of haematuria in all patients but two (97.5%). At 3 months, serum creatinine levels increased in four of nine patients with a solitary kidney, but only one of them required haemodialysis. After a mean follow‐up of 4.6 years, IVU showed a normal calyceal configuration in 70% of renal units, pyelonephritic changes in 26% and no dye excretion in 4%. DMSA scans showed no evidence of photopenic areas in 17 renal units (21%). The mean (sd) percentage of DMSA uptake by the corresponding kidney improved from 24 (9)% at the 3‐month scans to 32 (10)% at the last follow‐up scan (P < 0.001). Using MAG3, the mean (sd) glomerular filtration rate improved significantly from 26 (11) mL/min at the 3‐month scan to 32 (9) mL/min at the last follow‐up (P < 0.05).CONCLUSIONSSuperselective TAE is safe and effective for traumatic renal vascular injury. The short‐term deleterious effects were more pronounced in patients with a solitary kidney. The long‐term follow‐up showed functional and morphological improvements in the embolized renal units.
Efficacy of low‐dose dexamethasone in castration‐refractory prostate cancer
Authors: Venkitaraman Ramachandran , Thomas Karen , Huddart Robert A. , Horwich Alan , Dearnaley David P. , Parker Chris C. 
Published: October 2007

OBJECTIVETo evaluate the prostate‐specific antigen (PSA) response rate and duration of PSA response to dexamethasone in patients with castration‐refractory prostate cancer (CRPC), as corticosteroids are frequently used as second‐line hormonal treatment of CRPC and there is little published evidence concerning the efficacy of low‐dose dexamethasone in this setting.PATIENTS AND METHODSIn all, 102 patients with progressive CRPC received oral dexamethasone (0.5 mg daily) between January 2003 and October 2006. The median pretreatment PSA level was 83 ng/mL. The main endpoint was the PSA response rate according to the PSA Working Group criteria.RESULTSIn all, 50 patients (49%) had a confirmed PSA response. The median (range) time to PSA progression for the entire cohort was 7.4 (1–28) months. In responders, the median duration of the PSA response was 11.6 (1–24) months.CONCLUSIONLow‐dose dexamethasone has significant activity in CRPC. Subject to validation with more clinically meaningful endpoints, dexamethasone could become the corticosteroid of choice in the management of CRPC, and its potential for use in combination with novel agents should be explored.
Acute pyelonephritis: comparison of diagnosis with computed tomography and contrast‐enhanced ultrasonography
Authors: Mitterberger Michael , Pinggera Germar M. , Colleselli Daniela , Bartsch Georg , Strasser Hannes , Steppan Ilona , Pallwein Leo , Friedrich Aigner , Gradl Johann , Frauscher Ferdinand 
Published: October 2007

OBJECTIVETo assess the value of contrast‐enhanced ultrasonography (US) with the contrast pulse‐sequence (CPS) technique for detecting renal parenchymal changes in acute pyelonephritis (APN), compared with contrast‐enhanced computed tomography (CT) as the reference standard.PATIENTS AND METHODSWe examined 100 patients (82 women, 18 men; mean age 30.2 years, range 18–67); children (those aged <18 years) were excluded from the study. All patients had clinical symptoms suggestive of APN. For the US a Sequoia 512 (Acuson, Mountain View, CA, USA) unit including CadenceTM CPS technology, with a 6C2 probe, was used. A bolus of a 2.4‐mL US contrast agent SonoVue (Bracco, Milan, Italy) was injected. For CT a multislice 16‐row unit was used (Sensation 16, Siemens, Erlangen, Germany), at a table speed of 2.5 mm/s and a slice thickness of 3 mm; 100 mL of intravenous iodinated contrast agent (flow 3 mL/s) was injected.RESULTSOn contrast CT, 84 patients (84%) had renal parenchymal changes suggestive of APN; on contrast US, 82 of the 84 (98%) showed renal parenchymal changes, and APN was correctly diagnosed. Seventy‐six patients (90%) had unilateral and eight (10%) had bilateral APN, and in two (2%) with APN the diagnosis could not be confirmed by US/CPS (false‐negative). No false‐positive findings were detected on US/CPS, which had a sensitivity of 98%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 89%.CONCLUSIONCPS/US is accurate for detecting parenchymal changes in APN; it is very sensitive and specific, and allows small renal parenchymal changes to be detected with no radiation exposure.
Diabetic neuropathy is closely associated with arterial stiffening and thickness in Type 2 diabetes
Authors: Yokoyama H. , Yokota Y. , Tada J. , Kanno S. 
Published: October 2007

AbstractAims  Interaction of vascular and metabolic factors appears to contribute to the pathogenesis of diabetic neuropathy. The aim of the study was to assess the impact of arterial stiffening and thickness on diabetic neuropathy in Type 2 diabetes.Methods  In 294 patients with Type 2 diabetes, neuropathy was assessed by four components: the presence of neuropathic symptoms, the absence of ankle tendon reflexes, perception of vibration scores and heart rate variation. We measured intima‐media thickness (IMT) of carotid arteries to assess arterial thickening, and brachial–ankle pulse‐wave velocity (PWV) and brachial pulse pressure (PP) which reflect arterial stiffening.Results  Diabetic neuropathy, defined as ≥ two of the four components, was significantly associated with age, duration, glycated haemoglobin (HbA1c), systolic blood pressure, diastolic blood pressure, PP, hypertension, retinopathy, urinary albumin excretion rate, nephropathy stages, PWV and IMT. PWV and PP were significantly associated with neuropathy independent of conventional cardiovascular risk factors. Multiple logistic regression analysis revealed that PWV, retinopathy, age, and HbA1c, were significant independent determinants of neuropathy.Conclusions  The present cross‐sectional study indicates that markers for vascular wall properties such as PWV, IMT and PP are significantly associated with diabetic neuropathy. PWV and PP are significant determinants of neuropathy independent of conventional cardiovascular risk factors. Multifactorial intervention to inhibit progression of the atherosclerotic process may slow progression of neuropathy.
Usefulness of a new indicator test for the diagnosis of peripheral and autonomic neuropathy in patients with diabetes mellitus
Authors: Liatis S. , Marinou K. , Tentolouris N. , Pagoni S. , Katsilambros N. 
Published: October 2007

AbstractAims  The aim of the present study was to assess the performance of a new indicator test (NIT), based on the measurement of sweat production after exposure to dermal foot perspiration, in the diagnosis of both peripheral sensorimotor polyneuropathy (PSN) and autonomic neuropathy in patients with diabetes.Methods  One hundred and seventeen diabetic patients were examined. PSN was assessed using the neuropathy symptoms score, the neuropathy disability score and the vibration perception threshold. Cardiac autonomic neuropathy (CAN) was assessed using the battery of the four classical standardized tests proposed by Ewing et al., Diabetes Care 1985; 8: 491–498. Sudomotor dysfunction was assessed using the NIT.Results  Fifty patients (42.7%) had PSN and 44 patients (37.6%) had CAN. Of the 50 patients with PSN, 43 had a positive NIT (sensitivity 86%) and, out of the 67 patients without PSN, a negative NIT was obtained in 45 patients (specificity 67%). The positive and the negative predictive value of the NIT in detecting PSN were 66.2 and 86.5%, respectively. The sensitivity and specificity of NIT in detecting CAN was 59.1 and 46.5%, respectively. In the case of severe CAN, the sensitivity was increased to 80.9% and the specificity to 50%.Conclusions  The NIT has good sensitivity and negative predictive value for diagnosis of PSN and can be used as a screening method for detection of this complication in patients with diabetes. In addition, the test has a low sensitivity for detection of autonomic neuropathy in patients with milder forms of CAN.
Uterine artery embolisation or hysterectomy for the treatment of symptomatic uterine fibroids: a cost‐utility analysis of the HOPEFUL study
Authors: Wu O , Briggs A , Dutton S , Hirst A , Maresh M , Nicholson A , McPherson K 
Published: October 2007

Objectives  To evaluate the relative cost‐effectiveness of uterine artery embolisation (UAE) and hysterectomy in women with symptomatic uterine fibroids from the perspective of the UK NHS.Design  Cost‐utility analysis.Setting  Eighteen UK NHS hospital trusts.Population or sample  Women who underwent UAE (n= 649; average follow up of 8.6 years) or hysterectomy (n= 459; average follow up of 4.6 years) for the treatments of symptomatic fibroids.Methods  A probabilistic decision model was carried out based on data from a large comparative cohort and the literature. The two interventions were evaluated over the time horizon from the initial procedure to menopause. Extensive sensitivity analysis was carried out to test model assumptions and parameter uncertainties.Main outcome measures  Costs of procedures and complications and quality of life expressed as quality‐adjusted life years (QALYs).Results  Overall, UAE was associated with lower mean cost (£2536 versus £3282) and a small reduction in quality of life (8.203 versus 8.241 QALYs) when compared with hysterectomy. However, when the quality of life associated with the conservation of the uterus was incorporated in the model, UAE was shown to be the dominant strategy—lower costs and greater QALYs.Conclusions  UAE is a less expensive option to the health service compared with hysterectomy, even when the costs of repeat procedures and associated complications are factored in. The quality of life implications in the short term are also predicted to favour UAE; however, this advantage may be eroded over time as women undergo additional procedures to deal with recurrent fibroids. Given the hysterectomy is the current standard treatment for symptomatic fibroids, offering women UAE as an alternative treatment for fibroids is likely to be highly cost‐effective for those women who prefer uterus‐conserving treatment.
A UK multicentre retrospective cohort study comparing hysterectomy and uterine artery embolisation for the treatment of symptomatic uterine fibroids (HOPEFUL study): main results on medium‐term safety and efficacy
Authors: Dutton S , Hirst A , McPherson K , Nicholson T , Maresh M 
Published: October 2007

Objectives  Comparison of medium‐term safety and efficacy of hysterectomy and uterine artery embolisation (UAE) for symptomatic uterine fibroids.Design  Multicentre retrospective cohort.Setting  18 UK NHS hospital trusts.Participants  Four hundred and fifty nine women who had hysterectomy within a national audit during 12 months from October 1994 (VALUE study) (average follow up of 8.6 years) and 649 women receiving UAE from 1996 to 2002 (average follow up of 4.6 years).Methods  Clinical data from existing hospital records and patient completed postal questionnaires.Main outcome measures  Complication rates, side effects of embolisation, satisfaction with treatment, relief from symptoms and requirement for further fibroid treatment.Results  Fewer complications were experienced by women receiving UAE (19 versus 26% hysterectomy, P= 0.001), the adjusted odds ratio for UAE versus hysterectomy was 0.48 (95% CI 0.26–0.89). One‐third of women undergoing UAE experienced anticipated general side effects associated with the procedure. More women in the hysterectomy cohort reported relief from fibroid symptoms (95 versus 85%, P < 0.0001) and feeling better (96 versus 84%, P < 0.0001), but only 85% would recommend the treatment to a friend compared with 91% in the UAE arm (P= 0.007). There was a 23% (95% CI 19–27%) chance of requiring further treatment for fibroids after UAE. Twenty‐seven women who had had UAE reported 37 pregnancies after treatment resulting in 19 live births.Conclusions  UAE results in fewer complications than hysterectomy. Side effects after embolisation should be anticipated, and almost one‐quarter of women having UAE were likely to require further treatment for fibroid symptoms. Both treatments appear to be safe and effective over the medium term, and the choice of treatment may be a matter of personal preference for each individual woman.
Current access to health information in Zambia: a survey of selected health institutions
Authors: Hoppenbrouwer Joost , Kanyengo Christine Wamunyima 
Published: October 2007

AbstractObjective:  To assess the current situation of access to information by health staff at selected central, provincial, district hospitals and health centres in Zambia.Methods:  Government and non‐governmental institutions were visited in the Lusaka Urban District and nine rural districts in the North‐Western, Western and Central Provinces of Zambia in 2001. Thirty interviews were held with provincial and district health directors, medical doctors, nurses and clinical officers in district hospitals and rural and urban health centres. In 2006, a follow‐up visit was undertaken to the health centres in the Lusaka Urban District in Lusaka Province and the Sesheke District in the Western Province.Results:  There is limited access to health information for health workers in Zambia. In hospitals and health centres, where there is access, it is usually provided in an ad hoc manner without a central policy from the government. In all the places visited, there was also an overwhelming expressed need for different types of information relating to the professional or personal needs of health care workers.Conclusions:  The study found that access to information was very poor. There were some excellent examples of local initiatives showing that, even under difficult financial and infrastructural circumstances, it was feasible to improve health workers’ access to information by using low technology, information access initiatives. These existing local initiatives deserve to be scaled up, while new initiatives should be adopted to improve access to information in a much more structured way. Of paramount importance is the formulation and implementation of an information policy that will guarantee the provision of health information to Zambian health workers.
Direct binding of α‐actinin enhances TRPP3 channel activity
Authors: Li Qiang , Dai Xiao‐Qing , Shen Patrick Y. , Wu Yuliang , Long Wentong , Chen Carl X. , Hussain Zahir , Wang Shaohua , Chen Xing‐Zhen 
Published: October 2007

AbstractTransient receptor potential (TRP) polycystin 2 and 3 (TRPP2 and 3) are homologous members of the TRP superfamily of cation channels but have different physiological functions. TRPP2 is part of a flow sensor, and is defective in autosomal dominant polycystic kidney disease and implicated in left–right asymmetry development. TRPP3 is reported to implicate in sour tasting in bipolar cells of taste buds of the tongue and in the regulation of pH‐sensitive action potential in neurons surrounding the central canal of spinal cord. TRPP3 is present in both excitable and non‐excitable cells in various tissues, such as retina, brain, heart, testis, and kidney, but its common and cell type‐specific functional characteristics remain largely unknown. In this study, we investigated physical and functional interactions between TRPP3 and α‐actinin, an actin‐bundling protein known to regulate several types of ion channels. We employed planer lipid bilayer electrophysiology system to study the function of TRPP3 channel that was affinity‐purified from Madin–Darby canine kidney cells. Upon reconstitution in bilayer, TRPP3 exhibited cation channel activities that were substantially augmented by α‐actinin. The TRPP3‐α‐actinin association was documented by co‐immunoprecipitation using native cells and tissues, yeast two‐hybrid, and in vitro binding assays. Further, TRPP3 was abundantly present in mouse brain where it associates with α‐actinin‐2. Taken together, α‐actinin not only attaches TRPP3 to the cytoskeleton but also up‐regulates TRPP3 channel function. It remains to be determined whether the TRPP3‐α‐actinin interaction is relevant to acid sensing and other functions in neuronal and non‐neuronal cells.
Health‐related quality of life and intellectual functioning in children in remission from acute lymphoblastic leukaemia
Authors: Reinfjell Trude , Lofstad G Elisabeth , Veenstra Marijke , Vikan Arne , Diseth Trond H 
Published: October 2007

AbstractAim: To evaluate the health‐related quality of life (HRQOL) and intellectual functioning of children in remission from acute lymphoblastic leukaemia (ALL).Methods: Children and adolescents treated for ALL (n = 40; mean age 11.8 years, range 8.5–15.4) and healthy controls (n = 42; mean age 11.8, range 8.11–15.0) were assessed through a cross‐sectional approach using the Pediatric Quality of Life inventory (PedsQL™) 4.0 and the Wechsler Intelligent Scale for children‐III (WISC‐III).Results: Children and adolescents treated for ALL reported on average significantly lower HRQOL compared to healthy controls: the mother's proxy‐report showed significantly lower HRQOL for their children, as did the father's proxy‐report, measured by the PedsQL™ 4.0 Total Scale and Psychosocial Health Scale. Intellectual functioning as measured by the WISC‐III Full Scale IQ was below that of the control group, but still within the normal range.Conclusions: Significant differences found between children treated for ALL and their control group for the PedsQL Psychosocial Health Scale may indicate that the complex illness‐treatment experience can make children more vulnerable with regard to psychosocial sequels, in spite of otherwise satisfactory physical and intellectual functioning. Follow‐up programs that target the psychosocial health of children in remission from ALL should be implemented.
Isolated extraordinary daytime urinary frequency of childhood: a case series of 26 children in Switzerland
Authors: Corigliano Teresa , Renella Raffaele , Robbiani Anna , Riavis Mauro , Bianchetti Mario G 
Published: October 2007

AbstractBackground: The term ‘isolated extraordinary daytime urinary frequency’ designates an abnormally increased diurnal frequency of painless urination in a completely toilet‐trained child with normal urinalysis.Methods: We report the history of 26 children (16 boys and 10 girls; aged between 4.1 and 10 years) who were referred to us between 2002 and 2006 and subsequently diagnosed with this condition.Results: Possible psychosocial problems, or recent emotional stressors, were disclosed in the majority of the children: recent (36 months or less) asylum seekers (n = 9), school‐related problems (n = 4), parental divorce (n = 2) or death of the mother (n = 1). Possible dietary causes were observed in 9 patients: oxalate‐rich beverages (n = 5) and liberal ingestion of ‘acidic’ juices (n = 4). A diet low in oxalates was recommended when children were consuming large quantities of oxalate‐rich beverages; and a diet low in acidic juice was recommended in those liberally ingesting acidic juices. Reassurance and observation were the approach in the remaining cases. The median duration of the symptoms was 5 months. A longer (p < 0.05) duration was noted in children of asylum seekers.Conclusions: This functional condition is easily identifiable, but often under‐ or misdiagnosed. Confounding the condition might result in redundant investigation.
Risk factors in childhood obesity—findings from the All Babies In Southeast Sweden (ABIS) cohort
Authors: Huus Karina , Ludvigsson Jonas F , Enskär Karin , Ludvigsson Johnny 
Published: October 2007

AbstractAim: Our objective was to investigate whether overweight at a very young age predicts overweight at 5 years and to identify risk factors for overweight/obesity at 5 years, thereby making it easier for Child Health Services to focus their prevention strategies on risk groups.Methods: We analysed data from the ABIS study (All Babies In Southeast Sweden), a prospective cohort study. Parents answered questionnaires between childbirth (n = 16,058) and 5 years (n = 7356).Results: High body mass index (BMI; >95th percentile) at 1 year (adjusted odds ratio [AOR]= 6.57; 95% CI = 4.63–9.33; p < 0.001) and age‐adjusted BMI > 25 at 2.5 years (AOR = 14.24; 95% CI = 10.52–19.29; p < 0.001) were associated with increased risk of obesity (age‐adjusted BMI > 30) at 5 years. Heredity for type 2 diabetes (p = 0.022), high parental BMI and the child's own BMI at birth and at 1 year predicted higher BMI of the child at 5 years (p < 0.001). High parental education was inversely associated with child overweight (p = 0.054 respective p < 0.005).Conclusion: Obesity at age 1 and at 2.5 years predicts obesity at 5 years. Obese parents, especially in families with heredity for type 2 diabetes and low education, should be targeted in early obesity prevention strategies by the Child Health Service.
Oestrogen receptors and linear bone growth
Authors: Chagin Andrei S. , Sävendahl Lars 
Published: October 2007

AbstractIn this review we summarize available data regarding linear growth in oestrogen receptor alpha (ERα)‐ and oestrogen receptor beta (ERβ)‐deficient mice. We discuss these findings in relation to known oestrogenic effects in humans and the possibility of applying this knowledge for the therapeutic modulation of longitudinal bone growth employing selective oestrogen receptor modulators (SERMs). We conclude that SERMs potentially could offer new possibilities to modulate bone growth by specifically targeting different oestrogen receptors within the growth plate.
Association of n‐6 long‐chain polyunsaturated fatty acids to −866 G/A genotypes of the human uncoupling protein 2 gene in obese children
Authors: Bokor Szilvia , Csernus Katalin , Erhardt Éva , Burus István , Molnár Dénes , Decsi Tamás 
Published: October 2007

AbstractAim: To investigate the association of plasma fatty acids with the −866 G/A polymorphism of uncoupling protein 2 (UCP2) in obese children.Methods: Fatty acid composition of plasma phospholipids and sterol esters were investigated in 80 obese children.Results: Values of dihomo‐γ‐linolenic acid (C20:3n‐6) were significantly lower in children with the −866 A/A (n = 12) than in those with the −866 G/A (n = 34) or −866 G/G (n = 34) genotype in plasma phospholipids (3.01 [0.42] vs. 3.56 [1.02] vs. 3.53 [0.84], % weight/weight, median [interquartile range], p < 0.05), and were significantly lower in children with the −866 A/A genotype than in the other two groups in plasma sterol esters (0.73 [0.22] vs. 0.92 [0.23] vs. 0.94 [0.25], p < 0.05). Phospholipid C20:3n‐6 and arachidonic acid (C20:4n‐6) values showed only in children with the −866 G/G and −866 G/A genotypes significant positive correlations with plasma insulin concentrations.Conclusions: Significantly lower values of C20:3n‐6 can be detected in obese children with the homozygous (−866 A/A) mutation of UCP2 than in equally obese children with heterozygous mutation or the normal genotype. High glucose‐stimulated insulin response is associated with high plasma C20:3n‐6 and C20:4n‐6 values only in obese children with the G allele of the −866 G/A polymorphism.