bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is continent diversion using the Mitrofanoff principle a viable long‐term option for adults requiring bladder replacement?
Authors: Sahadevan Kanagasabai , Pickard Robert S. , Neal David E. , Hasan Tahseen S. 
Published: February 2008

OBJECTIVETo audit the long‐term outcome of patients with Mitrofanoff continent urinary diversion (MUD) to inform counselling of future patients concerning the procedure.PATIENTS AND METHODSAll patients who underwent MUD between 1990 and 2003 were identified. Continence, urinary tract infection (UTI), calculus formation and renal function were assessed by chart review and interviews.RESULTSOf the 29 patients identified 12 were women and 17 men with a mean (range) age of 48 (18–79) years at operation. The median (range) follow‐up was 126 (5–190) months. On questioning, 25 of 28 (89%) patients stated that they were continent. There was more than one confirmed UTI per year in two patients. Half of the patients had at least two UTIs within the follow‐up period but with no deterioration in renal function. Calculi developed in eight (29%) patients; four with bladder, three with renal and one with both renal and bladder calculi. Stomal stenosis developed in 15 (54%) patients requiring intervention at a mean (range) rate of 0.4 (0.1–2.4) episodes per year and nine ultimately required stomal reconstruction. Five (18%) patients required conversion to ileal conduit, two of these for persistent incontinence and three for recurrent stomal complications, at a mean (range) of 82  (9–140) months.CONCLUSIONSMUD is effective in offering continence with no major deterioration of renal function; however, this needs to be balanced against the need for subsequent additional interventions for stomal stenosis, stone formation and UTI on an individual basis.
Modified technique for neurovascular bundle preservation during radical prostatectomy: association between technique and recovery of erectile function
Authors: Masterson Timothy A. , Serio Angel M. , Mulhall John P. , Vickers Andrew J. , Eastham James A. 
Published: February 2008

OBJECTIVESTo prospectively evaluate whether a modified surgical technique for neurovascular bundle (NVB) preservation during radical prostatectomy (RP) is associated with an improvement in erectile function (EF) recovery after RP.PATIENTS AND METHODSData from patients treated before technique modification was used to create a predictive model for EF at 6 months after RP using age, date of surgery, and nerve sparing (none vs unilateral vs bilateral) as predictors for patients who received the modified technique (MT) to estimate the expected outcomes had they received the standard technique (ST), and compared these with actual outcomes. In the MT, the neurovascular bundle (NVB) is completely mobilized off the prostate from the apex to above the seminal vesicles including incision of Denonvilliers’ fascia before urethral division and mobilization of the prostate off the rectum.RESULTSOf 372 patients with evaluable data, 275 (74%) underwent the ST from 1 January 2001 to 31 December 2004 and 97 (26%) underwent the MT from 1 January 2005 to 30 May 2006. Sixty‐five of 97 patients (67%) receiving the MT had EF recovery at 6 months, whereas the expected probability of 6‐month recovery of EF, had they received the ST, was 45%. The absolute improvement in EF recovery attributable to the MT was 22% (95% confidence interval 5–40%; P = 0.013).CONCLUSIONSTechnical modifications to NVB preservation during RP were associated with improved rates of EF recovery.
Comparison of four systems of classification of diabetic foot ulcers in Tanzania
Authors: Abbas Z. G. , Lutale J. K. , Game F. L. , Jeffcoate W. J. 
Published: February 2008

AbstractAims  The aim was to compare the use of four different systems of foot ulcer classification in a consecutive population with diabetes presenting to a specialist clinic in Dar es Salaam, Tanzania.Methods  Clinical data were collected prospectively in all patients presenting with foot ulcers between 3 January 2003 and 30 September 2005, and were used retrospectively to classify their ulcers using the Meggitt/Wagner, University of Texas (UT), Size (Area and Depth), Sepsis, Arteriopathy, and Denervation [S(AD)SAD] and Perfusion, Extent/size, Depth/tissue loss, Infection and Sensation (PEDIS) systems. Comparison was made between the strength of the associations between baseline characteristics of each system and outcome determined at 5 December 2005, using linear by linear association.Results  The strongest statistical associations (P < 0.001) were observed between percent healing and Wagner score (χ2= 85.923), depth [S(AD)SAD, PEDIS and UT grade, 70.558], infection [S(AD)SAD, 61.774; PEDIS, 37.924] and UT stage (32.929). Weaker but significant (P < 0.001) associations were observed between percent healing and neuropathy [S(AD)SAD, PEDIS 12.475] and peripheral arterial disease [S(AD)SAD, PEDIS 10.799], as well as cross‐sectional area [S(AD)SAD 4.387, P = 0.036].Conclusion  The strength of the statistical association between outcome and both neuropathy and infection contrasts with findings in series previously reported from the USA and UK, and highlights the differences which may be found in different populations. These differences have implications for any system of classification chosen to compare the effectiveness of management in different centres in different countries.
Diabetes care in hospital—the impact of a dedicated inpatient care team
Authors: Flanagan D. , Moore E. , Baker S. , Wright D. , Lynch P. 
Published: February 2008

AbstractAims  At any given time, people with diabetes occupy approximately 5–10% of acute hospital beds. In addition, diabetes is associated with a greater length of stay (LOS). This is partially because of increased complexity of the cases but also because of unfamiliarity of dealing with the condition by other specialist teams.Methods  In 2002, with increasing pressure on acute hospital beds, a team was established to improve the care of inpatients with diabetes admitted to Derriford Hospital. The team consisted of five diabetes specialist nurses dedicated to inpatient care, supported by a consultant and specialist registrar diabetologist. A link nurse responsible for diabetes was appointed on every ward and each individual with a diagnosis of diabetes was identified on admission. We have compared LOS of all patients with diabetes admitted between January 2002 and December 2006.Results  LOS fell from a mean ± se of 8.3 ± 0.18 days in 2002 to 7.7 ± 0.10 days in 2006 (P = 0.002). Significant falls were seen for emergency admissions (9.7 ± 0.23 vs. 9.2 ± 0.20, P < 0.001) but not elective admissions. The data show significant reductions in LOS for medical admissions (9.2 ± 0.24 vs. 8.4 ± 0.20, P < 0.001) but not surgical admissions. Over the same period, LOS for the total hospital population fell by 0.3 days (P < 0.001).Conclusion  In conclusion, a team specifically employed to focus on inpatient diabetes care has a significant impact on LOS of this patient group.
Compliance with physical activity recommendations in US adults with diabetes
Authors: Zhao G. , Ford E. S. , Li C. , Mokdad A. H. 
Published: February 2008

AbstractAims  To investigate whether US adults with diabetes meet both the national and American Diabetes Association (ADA) recommendations for physical activity compared with people without diabetes, and to examine the trends of this behaviour over time.Methods  We analysed data from large nationally representative cohorts from the 1996–2005 Behavioral Risk Factor Surveillance System. The number of participants ranged from 98 127 in 1996 to 204 977 in 2005, and the number of people with diabetes ranged from 4379 in 1996 to 13 608 in 2005. Participants were classified by their exercise status and physical activity levels. The age‐standardized prevalence of physical activity participation or meeting physical activity recommendations was calculated in people with and without diabetes.Results  People with diabetes participated less in physical activity (63.1–68.9 vs. 71.7–78.3%) and met physical activity recommendations less than people without diabetes (40.2–42.9 vs. 48.0–51.5% for meeting national recommendations and 38.5–41.7 vs. 46.6–49.8% for meeting ADA recommendations). The percentage of people with diabetes who participated in physical activity in the past 10 years or met physical activity recommendations in the past 5 years did not vary, whereas significantly increasing trends were observed in people without diabetes. The odds for adults with diabetes meeting physical activity recommendations were significantly lower than in adults without diabetes even after multivariate adjustment.Conclusion  People with diabetes were less likely to meet either national or ADA recommendations for physical activity than people without diabetes. Our results demonstrate the need for more efforts from health‐care professionals to promote physical activity in people with diabetes.
Liraglutide, a once‐daily human GLP‐1 analogue, improves pancreatic B‐cell function and arginine‐stimulated insulin secretion during hyperglycaemia in patients with Type 2 diabetes mellitus
Authors: Vilsbøll T. , Brock B. , Perrild H. , Levin K. , Lervang H.‐H. , Kølendorf K. , Krarup T. , Schmitz O. , Zdravkovic M. , Le‐Thi T. , Madsbad S. 
Published: February 2008

AbstractAims  To assess the effect of liraglutide, a once‐daily human glucagon‐like peptide‐1 analogue on pancreatic B‐cell function.Methods  Patients with Type 2 diabetes (n = 39) were randomized to treatment with 0.65, 1.25 or 1.9 mg/day liraglutide or placebo for 14 weeks. First‐ and second‐phase insulin release were measured by means of the insulin‐modified frequently sampled intravenous glucose tolerance test. Arginine‐stimulated insulin secretion was measured during a hyperglycaemic clamp (20 mmol/l). Glucose effectiveness and insulin sensitivity were estimated by means of the insulin‐modified frequently sampled intravenous glucose tolerance test.Results  The two highest doses of liraglutide (1.25 and 1.9 mg/day) significantly increased first‐phase insulin secretion by 118 and 103%, respectively (P < 0.05). Second‐phase insulin secretion was significantly increased only in the 1.25 mg/day group vs. placebo. Arginine‐stimulated insulin secretion increased significantly at the two highest dose levels vs. placebo by 114 and 94%, respectively (P < 0.05). There was no significant treatment effect on glucose effectiveness or insulin sensitivity.Conclusions  Fourteen weeks of treatment with liraglutide showed improvements in first‐ and second‐phase insulin secretion, together with improvements in arginine‐stimulated insulin secretion during hyperglycaemia.
Quality of life and treatment satisfaction in adults with Type 1 diabetes: a comparison between continuous subcutaneous insulin infusion and multiple daily injections
Authors:   The EQuality1 Study Group—evaluation of QUALITY of life and costs in diabetes Type 1. Writing committee:, Nicolucci A. , Maione A. , Franciosi M. , Amoretti R. , Busetto E. , Capani F. , Bruttomesso D. , Di Bartolo P. , Girelli A. , Leonetti F. , Morviducci L. , Ponzi P. , Vitacolonna E. 
Published: February 2008

AbstractAims  The aim of this case–control study was to compare quality of life (QoL) and treatment satisfaction in adults with Type 1 diabetes (T1DM) treated with either continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI).Methods  Consecutive patients aged between 18 and 55 years, and attending diabetes clinics for a routine visit, completed the Diabetes‐Specific Quality‐of‐Life Scale (DSQOLS), the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and the SF‐36 Health Survey (SF‐36). Case (CSII) and control subjects (MDI) were recruited in a 1 : 2 ratio.Results  Overall, 1341 individuals were enrolled by 62 diabetes clinics; 481 were cases and 860 control subjects. Cases had a longer diabetes duration and were more likely to have eye and renal complications. Age, school education, occupation and HbA1c were similar. Of control subjects, 90% followed glargine‐based MDI regimens and 10% used NPH‐based MDI regimens. On multivariate analysis, after adjusting for socioeconomic and clinical characteristics, scores in the following areas of the DSQOLS were higher in cases than control subjects: diet restrictions (β = 5.96; P < 0.0001), daily hassles (β = 3.57; P = 0.01) and fears about hypoglycaemia (β = 3.88; P = 0.006). Treatment with CSII was also associated with a markedly higher DTSQ score (β = 4.13; P < 0.0001) compared with MDI. Results were similar when CSII was compared separately with glargine‐ or NPH‐based MDI regimens.Conclusions  This large, non‐randomized, case–control study suggests quality of life gains deriving from greater lifestyle flexibility, less fear of hypoglycaemia, and higher treatment satisfaction, when CSII is compared with either glargine‐based or NPH‐based MDI regimens.
Effect of acute hyperglycaemia and/or hyperinsulinaemia on proinflammatory gene expression, cytokine production and neutrophil function in humans
Authors: Stegenga M. E. , Crabben S. N. van der , Dessing M. C. , Pater J. M. , Van Den Pangaart P. S. , De Vos A. F. , Tanck M. W. , Roos D. , Sauerwein H. P. , Van Der Poll T. 
Published: February 2008

AbstractAims  Type 2 diabetes is frequently associated with infectious complications. Swift activation of leucocytes is important for an adequate immune response. We determined the selective effects of hyperglycaemia and hyperinsulinaemia on lipopolysaccharide (LPS)‐induced proinflammatory gene expression and cytokine production in leucocytes and on neutrophil functions.Methods  Six healthy humans were studied on four occasions for 6 h during: (i) lower insulinaemic euglycaemic clamp, (ii) lower insulinaemic hyperglycaemic clamp, (iii) hyperinsulinaemic euglycaemic clamp, and (iv) hyperinsulinaemic hyperglycaemic clamp. Target levels of plasma glucose were 12.0 mmol/l (hyperglycaemic clamps) or 5.0 mmol/l (euglycaemic clamps). Target plasma insulin levels were 400 pmol/l (hyperinsulinaemic clamps) or 100 pmol/l (lower insulinaemic clamps).Results  Hyperglycaemia reduced LPS‐induced mRNA expression of nuclear factor of κ light polypeptide gene enhancer in B cells inhibitor alpha (NFKBIA), interleukin‐1 alpha (IL1A) and chemokine (C‐C motif) ligand 3 (CCL3), whereas during hyperinsulinaemia enhanced mRNA levels occurred in six out of eight measured inflammation‐related genes, irrespective of plasma glucose levels. Combined hyperglycaemia and hyperinsulinaemia led to enhanced IL1A, interleukin‐1 beta (IL1B) and CCL3 mRNA levels upon LPS stimulation. Neither hyperglycaemia nor hyperinsulinaemia altered cytokine protein production, neutrophil migration, phagocytic capacity or oxidative burst activity.Conclusions  These results suggest that short‐term hyperglycaemia and hyperinsulinaemia influence the expression of several inflammatory genes in an opposite direction, that the acute effects of hyperinsulinaemia on inflammatory mRNA levels may be stronger than those of hyperglycaemia, and that the effects of insulin, in particular, may be relevant in the concurrent presence of hyperglycaemia.
Psychotherapy intervention to reduce depressive symptoms in patients with diabetic foot syndrome
Authors: Simson U. , Nawarotzky U. , Friese G. , Porck W. , Schottenfeld‐Naor Y. , Hahn S. , Scherbaum W. A. , Kruse J. 
Published: February 2008

AbstractAims  Compared to the population as a whole, patients with diabetes mellitus suffer a significantly higher rate of depressive symptoms, especially when they develop complications. Psychotherapy treatments in diabetes mellitus can lead to improvements in both depressive symptoms and glycaemic control. The objective of this study was to investigate whether depressive symptoms can be reduced by psychotherapy treatment delivered as a joint interdisciplinary service to in‐patients with diabetic foot syndrome and comorbid depression.Methods  Thirty in‐patients with diabetic foot syndrome and comorbid depression were randomized to either an intervention group (n = 15) with supportive psychotherapy treatment or a control group (n = 15) that received only standard medical treatment. Patients completed a set of questionnaires at the beginning and end of treatment. These recorded sociodemographic variables, anxiety and depression (Hospital Anxiety and Depression Scale) and diabetes‐related problems (Problem Areas in Diabetes Scale).Results  Although the diabetic foot syndrome improved significantly in 75% of patients, the extent of depressive symptoms and anxiety reported by the control group did not decrease by the end of treatment. In contrast, in the intervention group, anxiety, depression and diabetes‐related problems were all reduced. The extent of anxiety and depression was not, as had been anticipated, associated with the severity of the physical symptoms.Conclusions  These results indicate that psychotherapeutic intervention during in‐patient treatment can have a positive influence on anxiety, depressive symptoms and diabetes‐related problems in patients with diabetic foot syndrome.
Relationship between mean blood glucose and glycated haemoglobin in Type 2 diabetic patients
Authors: Makris K. , Spanou L. , Rambaouni‐Antoneli A. , Koniari K. , Drakopoulos I. , Rizos D. , Haliassos A. 
Published: February 2008

AbstractAims  To correlate the values of MBG to HbA1c in Greek patients with Type 2 diabetes and/or metabolic syndrome.Methods  We followed up 140 Greek adult patients: 92 patients with Type 2 diabetes treated with insulin or oral glucose‐lowering medication, and 48 patients with newly diagnosed Type 2 diabetes or metabolic syndrome not receiving any treatment. MBG was calculated for each patient from self‐measurements of blood glucose using a portable glucometer, made six times a day (before eating and 2 h after a meal), three times a week for 1 month. HbA1c was determined by HPLC at 0 and 12 weeks.Results   HbA1c at 0 (x) and 12 weeks (y) correlated strongly (y = 0.790x + 1.115, r = 0.92), confirming that the patient's glycaemic status remained stable during the whole period of follow‐up. Linear regression was performed on MBG values; HbA1c at 12 weeks, sex, age, body mass index (BMI) and patient status (Type 2 diabetes treated or not) were used as independent variables. None of the independent variables reached statistical significance in the model, with the exception of HbA1c at 12 weeks. The final model was: MBG (mg/dl) = (34.74 × HbA1c) – 79.21, r = 0.93; or MBG (mmol/l) = 1.91 × HbA1c – 4.36, r = 0.93.Conclusions  Our results establish for the first time a strong correlation between MBG and HbA1c in Type 2 diabetic patients and support the idea of expressing HbA1c results as MBG. This will help patients to gain a clearer interpretation of the result, with less confusion. This simplification will allow every person with diabetes using home glucose‐monitoring to understand his or her own target level.
Impact of deprivation on cardiovascular risk factors in people with diabetes: an observational study
Authors: Wild S. , MacLeod F. , McKnight J. , Watt G. , MacKenzie C. , Ford I. , McConnachie A. , Lindsay R. S. 
Published: February 2008

AbstractAim  To examine the influence of deprivation on prevalence of diabetes and of cardiovascular disease risk factors in people with diabetes.Methods  Cross‐sectional study of 52 280 people in diabetes registers of Greater Glasgow and Lothian NHS Board areas linked to hospital admission data.Results  Age‐ and sex‐adjusted prevalence of diabetes increased from 2.3% in the least deprived quintile (Q1) to 3.3% in the most deprived quintile (Q5; P < 0.001), as did prevalence of vascular disease (Q1 20%, Q5 27%; P < 0.001). Prevalence of current smoking (Q1 13%, Q5 32%; P < 0.001), obesity (Q1 38%, Q5 51%; P < 0.001) and above‐target glycated haemoglobin (HbA1c; ≥ 7.5%: Q1 46% vs. Q5 47%; P = 0.01) were higher in the most deprived quintile. In contrast, the proportion of people with above‐target cholesterol were similar (proportion ≥ 5.0 mmol/l: Q1 26%, Q5 24%; P = 0.07) and the proportion of people with above‐target systolic blood pressure (SBP) was lower (SBP ≥ 140 mmHg: Q1 44%, Q5 37%; P = 0.02) in the most deprived quintile. In people with diabetes and prevalent vascular disease, deprivation was associated with failure to reach cholesterol target [odds ratio cholesterol ≥ 5.0 mmol/l: Q5 vs. Q1 1.23 (1.04–1.45) P = 0.013]. SBP and cholesterol were markedly lower compared with previous population surveys.Conclusions  The burden of diabetes and vascular disease is greater in more deprived populations. Our data confirm a major advance in management of cholesterol and blood pressure management. Deprivation is still associated with failure to reach cholesterol targets in secondary prevention as well as higher prevalence of obesity and smoking.
Does serum 1,5‐anhydroglucitol establish a relationship between improvements in HbA1c and postprandial glucose excursions? Supportive evidence utilizing the differential effects between biphasic insulin aspart 30 and insulin glargine
Authors: Moses A. C. , Raskin P. , Khutoryansky N. 
Published: February 2008

AbstractAim  To investigate the relationship between changes in glycated haemoglobin (HbA1c) and postprandial glucose excursions on 1,5‐anhydroglucitol (1,5‐AG) in patients with Type 2 diabetes, utilizing the differential effects between biphasic insulin aspart 30 (BIAsp 30) or insulin glargine (IGlar) on postprandial glucose (PPG) levels.Methods  1,5‐AG was measured using the GlycoMark® assay at baseline and after 12 and 28 weeks in the INITiation of Insulin to reach HbA1c Target (INITIATE) study of 233 patients randomized to either BIAsp 30 or IGlar.Results  Baseline 1,5‐AG was low and not significantly different (4.9 ± 3.5 and 4.3 ± 2.6 µg/ml in the BIAsp 30 and IGlar groups, respectively). After 28 weeks, the levels of 1,5‐AG were higher in the BIAsp 30 than in the IGlar group (13.4 vs. 11.1 µg/ml, P = 0.008) and change from baseline was 25% greater with BIAsp 30 than IGlar (8.4 vs. 6.7 µg/ml, P = 0.011). 1,5‐AG levels increased as a function of decreasing HbA1c or the average change in postprandial plasma glucose (PPGave) with significant relationships for 1,5‐AG/ HbA1c vs. HbA1c or 1,5‐AG/PPGave vs. PPGave (both P < 0.0001), respectively.Conclusions  As reported in previous publications, 1,5‐AG reflects ambient glycaemic control and increases with reductions in HbA1c and postprandial glucose. The greater reductions in postprandial excursion achieved with BiAsp 30 compared with glargine were associated with greater increases in 1,5‐AG. Even moderate elevations in HbA1c substantially lower 1,5‐AG, suggesting that it can be most discriminating in identifying patients with excessive postprandial glucose excursions at HbA1c levels that approach the upper end of the normal range.
Recent developments in calcium‐related obesity research
Authors: Major G. C. , Chaput J.‐P. , Ledoux M. , St‐Pierre S. , Anderson G. H. , Zemel M. B. , Tremblay A. 
Published: February 2008

SummaryThe influence of calcium and dairy food intake on energy balance is the object of a growing scientific literature. This manuscript presents the information discussed by subject experts during a symposium on calcium and obesity, initially planned to document in a comprehensive manner the role of calcium and dairy food on energy balance and body composition. This manuscript is organized into 13 propositions statements which either resume the presentation of an invited speaker or integrate recent developments in calcium‐related obesity research. More specifically, the effects of calcium and dairy consumption on body weight and adiposity level, appetite, weight loss intervention outcome, lipid‐lipoprotein profile and the risk to develop metabolic syndrome are discussed together with the metabolic mechanisms proposed to explain these effects. Taken together, the observations presented in this manuscript suggest that calcium and dairy food intake can influence many components of energy and fat balance, indicating that inadequate calcium/dairy intake may increase the risk of positive energy balance and of other health problems.