bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can home‐made injectable opiates contribute to the HIV epidemic among injection drug users in the countries of the former Soviet Union?
Authors: Abdala Nadia , Grund Jean‐Paul C. , Tolstov Yanis , Kozlov Andrei P. , Heimer Robert 
Published: March 2006

ABSTRACTAims  Home‐made preparation of heroin is common in countries of the former Soviet Union (FSU), and the addition of blood during its preparation and the use of contaminated syringes to distribute it may play a role in the rapid spread of HIV‐1 among injecting drug users (IDUs). This study was designed to determine the viability of HIV‐1 during these procedures.Setting  Field observations of home‐made opiate manufacture in four FSU countries were used to develop a consensus protocol to replicate manufacture in the laboratory that included the addition of human blood contaminated with HIV‐1.Design and measurement  Following the addition of HIV‐1‐contaminated blood during manufacture or storage, we attempted to recover viable HIV‐1. The recovery was measured by propagation of the virus in stimulated white blood cells from uninfected donors.Findings  In experiments in which HIV‐1 contaminated blood was added during manufacture, no viable HIV‐1 was recovered. In experiments in which chornaya was introduced into HIV‐contaminated syringes, the percentage of syringes containing viable HIV‐1 was reduced. The reduction appeared to be related to the interaction of HIV‐1 contaminated blood with a component of the poppies. While HIV‐contaminated syringes used to dispense or inject home‐made opiates might transmit HIV, the ability of chornaya to reduce HIV viability seems to make this route of transmission less efficient.Conclusions  The epidemic of HIV‐1 among IDUs in the FSU resulted more probably from recognized injection risk behaviors—including sharing syringes and drug solutions—than from opiate solutions harboring viable HIV‐1.
Bone health in autoimmune polyendocrinopathy–candidiasis–ectodermal dystrophy (APECED): findings in 25 adults
Authors: Mäkitie O. , Sochett E. B. , Bondestam S. , Sipilä I. , Perheentupa J. 
Published: March 2006

SummaryObjective  Autoimmune polyendocrinopathy–candidiasis–ectodermal dystrophy (APECED) is characterized by chronic mucocutaneous candidiasis and autoimmune destruction of endocrine organs. The resulting endocrinopathies and their treatment may impact bone health. The purpose of our study was to assess bone health and its correlates in adult patients with APECED.Patients and methods  Twenty‐five adults (12 males) with APECED were prospectively assessed. Data on their previous medical history were collected from hospital records. Areal bone mineral density (aBMD) for the lumbar spine (L1–L4), femoral neck and whole body as well as volumetric BMD (vBMD) for the lumbar spine (L2–L4) were measured with dual‐energy X‐ray absorptiometry (DXA).Results  Mean age was 34 years (range 21–59 years). All patients had 1–4 autoimmune endocrinopathies, the most common being adrenocortical failure (20 patients) and hypoparathyroidism (18 patients). Osteopaenia or osteoporosis was present in 28%. The median (range) aBMD Z‐scores were for the lumbar spine −0·3 (−2·3 to +3·3) and for the femoral neck, −0·1 (−2·2 to +2·0). The BMD Z‐scores tended to be higher in patients with hypoparathyroidism than in patients with normal parathyroid function (at the lumbar spine +0·4 vs.–1·2, P = 0·016, and at the femoral neck +0·3 vs.−0·4, P = 0·090). Adrenocortical failure had a negative impact on BMD. Six patients had had low‐impact fractures and three were diagnosed with compression fractures.Conclusions  Despite the complex endocrine problems, the overall prevalence of symptomatic osteoporosis is low in adults treated for APECED. Osteopaenia is frequently observed and warrants follow‐up. Treated hypoparathyroidism may have a positive, and adrenocortical failure a negative, impact on bone health.
No effect of B vitamins on ADMA levels in patients at increased cardiovascular risk
Authors: Spoelstra‐de Man A. M. E. , Teerlink T. , Brouwer C. B. , Rauwerda J. A. , Stehouwer C. D. A. , Smulders Y. M. 
Published: March 2006

SummaryObjective  Asymmetric dimethylarginine (ADMA) is a recently identified potent cardiovascular risk factor. ADMA levels are increased in hyperhomocysteinaemia and the metabolism of ADMA is linked with that of homocysteine in several ways. Treatment with B vitamins effectively reduces homocysteine levels, but studies investigating the effect on ADMA levels are scarce and show conflicting results. In this study we evaluated the effect of treatment with B vitamins on ADMA levels in two high cardiovascular risk populations.Methods  In study I, 110 siblings of patients with clinical atherosclerotic disease and postmethionine hyperhomocysteinaemia were treated with 5 mg of folic acid and 250 mg of pyridoxine or placebo, and were analysed after 1 year. In study II, 41 patients with type 2 diabetes and mild hyperhomocysteinaemia were analysed after 6 months treatment with 5 mg of folic acid or placebo.Results  A correlation between baseline homocysteine and ADMA levels was found, which was partly due to confounding by renal function. Homocysteine levels decreased by 43% in study I and by 28% in study II. In both studies, treatment with B vitamins had no effect at all on ADMA, arginine/ADMA ratio and SDMA levels. This result was confirmed in multiple linear regression analyses with adjustment for baseline values and gender.Conclusions  Our studies indicate that B vitamins, despite causing a substantial reduction in plasma homocysteine levels, have no beneficial effect on ADMA levels.
Treatment with the aromatase inhibitor letrozole during adolescence increases near‐final height in boys with constitutional delay of puberty
Authors: Hero Matti , Wickman Sanna , Dunkel Leo 
Published: March 2006

SummaryObjective  We investigated whether inhibition of oestrogen biosynthesis with the aromatase inhibitor, letrozole, during adolescence improves near‐final height in boys with constitutional delay of puberty.Patients and methods  Seventeen boys with constitutional delay of puberty were randomized to receive testosterone (T) enanthate (1 mg/kg i.m.) every 4 weeks for 6 months in combination with placebo (Pl, n = 8), or the aromatase inhibitor letrozole (Lz, 2·5 mg/day orally) (n = 9), for 12 months. After treatment, patients were followed up until near‐final height. Height discrepancy was calculated as near‐final height minus mid‐parental target height.Measurements  The primary end point was the difference in near‐final height between the groups treated either with T + Pl or T + Lz. Secondarily, height discrepancy and gain in height standard deviation score (SDS) were analysed in both groups.Results  Boys treated with T + Lz reached a higher mean near‐final height than did boys on T + Pl (175·8 vs. 169·1 cm, respectively, P = 0·04). In T + Lz‐treated boys, mean near‐final height did not differ from their mid‐parental target height (175·8 vs. 177·1 cm, P = 0·38), whereas in T + Pl‐treated boys, mean near‐final height was lower than mid‐parental target height (169·1 vs. 173·9 cm, P = 0·007). T + Lz‐treated boys had a greater increment in height SDS over the pretreatment height SDS than T + Pl‐treated boys (+1·4 SDS vs.+0·8 SDS, P = 0·03).Conclusions  Our findings indicate that in adolescent boys an increase in adult height can be attained by use of aromatase inhibitors.
The prevalence of hypovitaminosis D and secondary hyperparathyroidism in obese Black Americans
Authors: Yanoff Lisa B. , Parikh Shamik J. , Spitalnik Amanda , Denkinger Blakeley , Sebring Nancy G. , Slaughter Pamela , McHugh Theresa , Remaley Alan T. , Yanovski Jack A. 
Published: March 2006

SummaryContext  Both obesity (body mass index, BMI ≥ 30 kg/m2) and Black race are associated with a higher risk of vitamin D deficiency and secondary hyperparathyroidism. We hypothesized the risk of hypovitaminosis D would therefore be extraordinarily high in obese Black adults.Objective  To study the effects of race and adiposity on 25‐hydroxyvitamin D [25(OH)D] and parathyroid hormone (iPTH).Design, Setting and Participants  Cross‐sectional study of 379 Black and White adults from the Washington D.C. area. BMI ranged from 19·9 to 58·2 kg/m2.Main Outcome Measures  Prevalence of hypovitaminosis D [25(OH)D < 37·5 nmol/l] and secondary hyperparathyroidism [25(OH)D < 37·5 nmol/l with iPTH > 4·2 pmol/l].Results  Obese Black subjects had lower mean 25(OH)D, 40·3 (SD, 20·3) nmol/l, compared with obese Whites, 64·5 (29·7), P < 0·001, nonobese Blacks, 53·3 (26·0), P = 0·0025 and nonobese Whites, 78·0 (33·5), P < 0·001. The prevalence of hypovitaminosis D increased with increasing BMI, and was greater (P < 0·001) in Blacks than Whites within all BMI categories examined. Among subjects with BMI ≥ 35 kg/m2, 59% of Blacks vs 18% of Whites had hypovitaminosis D (odds ratio 6·5, 95% confidence interval 3·0–14·2). iPTH was negatively correlated with 25(OH)D (r = –0·31, P < 0·0001), suggesting those with hypovitaminosis D had clinically important vitamin D deficiency with secondary hyperparathyroidism. For secondary hyperparathyroidism 35·2% of Blacks met the criteria, compared to 9·7% of Whites (OR 3·6, CI 1·5–98·8).Conclusions  Obese Black Americans are at particularly high risk for vitamin D deficiency and secondary hyperparathyroidism. Physicians should consider routinely supplementing such patients with vitamin D or screening them for hypovitaminosis D.
Differences in cortisol concentrations in South Asian and European men living in the United Kingdom
Authors: Reynolds Rebecca M. , Fischbacher Colin , Bhopal Raj , Byrne Christopher D. , White Martin , Unwin Nigel , Walker Brian R. 
Published: March 2006

SummaryObjective  The metabolic syndrome is more prevalent in South Asians in Britain than in the general population. Furthering our understanding of the underlying mechanisms is important because of the increased risk of cardiovascular disease associated with the metabolic syndrome. As it has been proposed that increased activity of the hypothalamic pituitary adrenal axis might underlie the metabolic syndrome, we hypothesized that plasma cortisol levels would be higher in South Asians and that increased cortisol levels would be associated with cardiovascular risk factors comprising the metabolic syndrome. The aim of the study was to examine ethnic differences in cortisol levels and to compare the relationships between cortisol levels and cardiovascular risk factors in men from different ethnic groups.Design  Cross‐sectional population‐based study, Newcastle upon Tyne, UK. (Newcastle Heart project).Participants  One hundred men, 40–67 years old, of European and South Asian (Indian, Pakistani, Bangladeshi) ancestry, with and without cardiovascular risk factors of the metabolic syndrome.Measurements  Measurement of plasma cortisol and corticosteroid binding globulin in stored sera.Results  After adjustment for age and the presence of cardiovascular risk factors, mean cortisol was 27% (95% CI, 10%, 40%) lower in South Asians compared to Europeans. Cortisol levels were higher in all men with cardiovascular risk factors than those without.Conclusions  Cortisol levels are lower in South Asian than in European men resident in the UK. Despite lower cortisol levels in South Asians, the relations between cortisol and cardiovascular risk factors remain strong.
Fractionated stereotactic conformal radiotherapy for secreting and nonsecreting pituitary adenomas
Authors: Minniti G. , Traish D. , Ashley S. , Gonsalves A. , Brada M. 
Published: March 2006

SummaryObjective  To assess the medium‐term outcome in a cohort of patients with residual or recurrent pituitary adenoma treated with fractionated stereotactic conformal radiotherapy (SCRT).Patients and methods  Ninety‐two patients (median age 50 years) with a residual or recurrent nonfunctioning (67) or a secreting (25) pituitary adenoma were treated between 1995 and 2003. Eighteen patients had a GH‐secreting, five PRL‐secreting and two an ACTH‐secreting pituitary adenoma. Vision was impaired in 39 patients, with visual field deficit (35) and/or reduced visual acuity (25). Sixty‐four patients had partial or complete hypopituitarism before SCRT. The treatment was delivered stereotactically by four noncoplanar conformal fixed fields using a 6‐MV linear accelerator to a dose of 45 Gy in 25 fractions.Results  At a median follow‐up of 32 months (range 4–108) the 1, 3 and 5 years actuarial progression‐free survival is 99%, 98% and 98%, and overall survival is 98%. Three patients recurred 5 months, 1 year and 9 years after SCRT requiring surgery. In secreting adenomas, hormone levels declined progressively, becoming normal in more than a third of patients with GH‐secreting and PRL‐secreting pituitary tumours. 50% of baseline GH level was achieved in just under 2 years. The treatment was well tolerated with minimal acute toxicity. Hypopituitarism was the most common long‐term effect; 22% of patients had worsening of pituitary function. One patient developed unilateral quadrantopia without tumour progression.Conclusion  SCRT as a high‐precision technique of localized irradiation achieves tumour and hormone control of pituitary adenomas comparable with previously published data on the efficacy of conventional radiotherapy. Despite the potential advantage of reducing the volume of normal brain irradiated, the theoretical benefit over conventional radiotherapy in terms of the reduction in long‐term morbidity has not yet been demonstrated and requires longer follow‐up. Potential effect on long‐term cognitive function has not been tested.
Persisting effects on fasting glucose levels and insulin sensitivity after 6 months of discontinuation of a very low‐dose GH therapy in adults with severe GH deficiency
Authors: Yuen Kevin C. J. , Dunger David B. 
Published: March 2006

SummaryObjective  We recently reported that, in contrast to the standard GH (SGH) replacement dose titrated to normalize serum IGF‐I levels, 12‐month treatment with a fixed low GH dose (LGH) (0·1 mg/day) decreased fasting glucose levels and improved insulin sensitivity with little effect on body composition in severely GH‐deficient adults. In this study, we have subsequently examined the effects after 6 months of discontinuation of these variable GH doses (LGH: n = 8; fixed dose 0·10 mg/day and SGH: n = 8; mean dose 0·50 mg/day) on glucose metabolism, body composition and other surrogate cardiovascular risk markers.Methods  Fasting insulin sensitivity using the homeostasis model assessment, and body composition using dual‐energy X‐ray absorptiometry scans were assessed at baseline, after 12 months of therapy (month 12) and after 6 months following discontinuation of therapy (month 18).Results  At month 12, the LGH decreased fasting glucose levels and improved insulin sensitivity without altering body composition, whereas the SGH improved body composition without modifying insulin sensitivity. Six months after discontinuation of the LGH treatment (month 18), fasting glucose levels remained decreased and the enhanced insulin sensitivity persisted. In contrast, after discontinuation of SGH treatment (month 18), body composition reverted to baseline without changes in either fasting glucose levels or insulin sensitivity.Conclusion  In contrast to the SGH, the LGH induces effects on fasting glucose levels and insulin sensitivity, which persist after 6 months of discontinuation of therapy. The exact molecular mechanisms are unclear but may involve the modulation of hepatic and muscle insulin sensitivity, possibly by altering insulin and IGF‐I receptor responsiveness and/or density.
Type I cytokine profiles of human naïve and memory B lymphocytes: a potential for memory cells to impact polarization
Authors: Gagro Alenka , Servis Drazen , Cepika Alma‐Martina , Toellner Kai‐Michael , Grafton Gillian , Taylor Dale R. , Branica Srecko , Gordon John 
Published: March 2006

SummaryB cells bifurcating along ‘type 1’ or ‘type 2’ pathways under the influence of polarizing cytokines can, in turn, influence the direction of an immune response. Here, we compare the capacity of human B cells residing within naïve and memory compartments to participate in type 1 polarizing responses. B‐cell receptor (BCR) engagement provided the main signal for interleukin (IL)‐12Rβ1 expression in the two subsets: this was potentiated by CD154 together with interferon‐γ (IFN‐γ) but inhibited by IL‐12. IL‐12Rβ2 could be induced on a minority of B cells by the same signals, and also by IFN‐γ alone. WSX‐1, a receptor for IL‐27, was expressed in both subsets with no evidence for its regulation by the signals studied. While neither subset was capable of secreting much IL‐12 p70, memory B cells could produce a small amount of IL‐12 p40 on CD40 ligation. Memory B cells also, exclusively, expressed IL‐23 p19 mRNA on BCR triggering. Importantly, products of appropriately stimulated memory – but not naive – B cells were shown to promote the synthesis of IFN‐γ in uncommitted T‐helper cells. The data indicate an equal capacity for naïve and memory B cells to respond within a type 1 polarizing environment. Although poorly equipped for initiating type 1 responses, B cells – by virtue of the memory subset – reveal a capacity for their maintenance and amplification following T‐dependent signalling.
Genetic control of immune‐mediated necrosis of Mycobacterium avium granulomas
Authors: Flórido Manuela , Appelberg Rui 
Published: March 2006

SummaryIntravenous infection of C57BL/6 and C57BL/10 mice with low doses of a highly virulent strain of Mycobacterium avium (ATCC 25291) led to the development of granulomas that underwent necrosis. In contrast, neither BALB/c nor DBA/1 mice developed granuloma necrosis after such infection despite a similar course of mycobacterial proliferation. Studies with C57BL/10 mice congenic for the Hc locus revealed that an intact complement C5 gene is required for granuloma necrosis. On the other hand, genetic disruption of the interleukin‐10 gene in BALB/c mice made this strain susceptible to granuloma necrosis.
Comprehensive osteoporosis management with easy access to bone mineral density measurements
Authors: Kullenberg Ragnar , Hanson Bengt , Sandberg Rolf , Dahlberg Hans 
Published: March 2006

AbstractBackground  The majority of people with osteoporosis are never evaluated even though effective treatments are available. The County Council of Värmland in Sweden has implemented an osteoporosis management model that has been shown to be effective in promoting awareness and providing care for osteoporosis patients. Discussions among a prevention group on osteoporosis in the county council were opened in 1997. The county of Värmland covers a large area, and the distances from the peripheral parts to the main city are approximately 300 km and cumbersome for the inhabitants. The importance of having an osteoporosis service that could reach the county inhabitants in a convenient way was therefore recognized.Methods  Three thousand four hundred patients were evaluated between March 2001 and December 2003. Guidelines for patient selection for bone density testing and treatment guidelines were formulated. Promoting awareness was an important prerequisite for the model to function. This was accomplished by having the measurement devices where the patients showed up and by regular education of the primary care doctors.Results and conclusions  A multidisciplinary team was established and consisted of primary care doctors, orthopaedic surgeons, internists, physiotherapists, a patient organization member, a county health care representative and nurses. Team members met every third month and agreed upon clinical guidelines for implementing the system. The presented osteoporosis management system is not a screening approach as all patients had risk factors for osteoporosis before they were suggested for bone density testing. This study shows that providing a comprehensive package of measures makes it possible to establish an effective osteoporosis management system with limited economical resources.
NGC 2401: a template of the young population of the Norma–Cygnus arm in the Third Galactic Quadrant
Authors: Baume G. , Moitinho A. , Vázquez R. A. , Solivella G. , Carraro G. , Villanova S. 
Published: March 2006

Abstract
Based on a deep optical CCD [UBV(RI)C] photometric survey and on the Two-Micron All Sky Survey (2MASS) data, we derived the main parameters of the open cluster NGC 2401. We found that this cluster is placed at 6.3 ± 0.5 kpc (VO−MV= 14.0 ± 0.2) from the Sun and is 25 Myr old, which allows us to identify NGC 2401 as a member of the young population belonging to the innermost side of the extension of the Norma–Cygnus spiral arm in the Third Galactic Quadrant. A spectroscopic study of the emission star LSS 440 that lies in the cluster area revealed that it is a B0Ve star; however, we could not confirm that it is a cluster member. We also constructed the cluster luminosity function (LF) down to V∼ 22 and the cluster initial mass function (IMF) for all stars with masses above M∼ 1–2 M⊙. It was found that the slope of the cluster IMF is x≈ 1.8 ± 0.2. The presence of a probable pre-main-sequence (PMS) star population associated with the cluster is weakly revealed.
Antenatal rubella serosurvey in Maputo, Mozambique
Authors: Barreto Jorge , Sacramento Isadora , Robertson Susan E. , Langa Judite , de Gourville Esther , Wolfson Lara , Schoub Barry D. 
Published: March 2006

SummaryObjective  To describe the epidemiology of rubella in Mozambique.Methods  Cross‐sectional serosurvey of rubella IgG antibodies among women attending antenatal clinics in Maputo in February–April 2002 to assess the prevalence and titres.Results  Rubella IgG antibodies were detected in 95.3% (95% confidence interval 94.0%–96.6%) of 974 pregnant women. Age and residence did not significantly affect the prevalence of rubella IgG antibodies. However, the mean titre of rubella IgG antibodies was higher in women <20 years of age than in women ≥30 years of age (P < 0.01), and women living in urban areas had higher antibody titres than those living in suburban areas (P < 0.0001).Conclusions  The seroprevalence of rubella IgG antibodies among pregnant women in Maputo is high. Whether this is due to recent exposure to wild rubella virus or to exposure to rubella virus earlier in life is unclear. Studies on the burden of congenital rubella syndrome could address this matter.