bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transgenic mouse brains for the evaluation and quality control of BSE tests
Authors: Philipp Wolfgang J. , Groth Darlene , Giles Kurt , Vodrazka Pavel , Schimmel Heinz , Feyssaguet Muriel , Toomik Reet , Schacher Pascal , Osman Awad A. , Lachmann Ingolf , Wear Angus , Arsac Jean-Noel , Prusiner Stanley B. 
Published: March 2007

Abstract
Rapid BSE tests are widely used diagnostics in veterinary medicine and more than 11 million tests are applied worldwide. The evaluation of new rapid BSE tests and the quality assurance of approved BSE tests pose a challenge owing to the natural scarcity of BSE-infected bovine brainstems and regional variations in prion titer. Transgenic mice expressing bovine prion protein (Tg4092) offer an alternative approach to these problems. To determine whether BSE-infected Tg4092 mouse brains could serve as a general standard for rapid BSE tests, we inoculated Tg4092 mice intracerebrally with BSE prions, harvested brains at defined time points post-infection and analyzed cerebral hemispheres with several approved rapid BSE tests. The results show that de novo formation of the disease-causing prion protein isoform, PrPSc, can be monitored during the course of infection. We demonstrate that BSE-infected Tg4092 mouse brains provide a renewable and controllable source of reference samples and suggest that such samples can generally be used for the evaluation and quality control of rapid BSE tests.
Effects of Enalapril in Insulin-Dependent Diabetic Subjects With Mild to Moderate Uncomplicated Hypertension
Authors: Passa Philippe , LeBlanc Hervé , Marre Michel 
Published: March 2007

The antihypertensive efficacy of enalapril and its effects on the metabolism and kidney function were investigated in 11 insulin-dependent diabetic subjects with uncomplicated mild to moderate hypertension. During a short-term single-blind controlled trial, one daily dose of 20 or 40 mg enalapril significantly reduced both systolic and diastolic blood pressure. In the supine position, mean systolic blood pressure declined from 169 ± 6 to 142 ± 6 mmHg (P &lt; .01) and mean diastolic blood pressure from 101 ± 1.5 to 85 ± 2 mmHg (P &lt; .001). No changes in heart rate or postural hypotension were observed.
During 1 yr of treatment, the antihypertensive efficacy of enalapril did not decline,and no clinical side effects were observed. Inhibition by enalapril of angiotensin-converting enzyme did not modify daily insulin requirements, glycemic control, uricemia, or lipid metabolism; kalemia and the markers of diabetic nephropathy were not significantly altered. These results suggest that enalapril once daily should be used as the first step inthe treatment of diabetic patients with mild to moderate hypertension.
Metabolic Control in Non-Insulin-Dependent Diabetes Mellitus: Factors Associated With Patient Outcomes
Authors: O'connor Patrick J , Fragneto Regina , Coulehan John , Crabtree Benjamin F 
Published: March 2007

We conducted a cross-sectional study to assess the association of various demographic and medical-care variables with metabolic outcomes in non-insulin-dependent diabetic subjects. The study population was representative of the diagnosed care-seeking diabetic population of a defined geographic community on the Navajo reservation in Arizona. The dependent variable metabolic control was measured as the mean of all random plasma glucose values obtained only at scheduled diabetes clinic visits over 2yr.
Multivariate analysis of the data showed that better metabolic control was most strongly associated with compliance with scheduled appointments. Mode of treatment was also associated with metabolic control. Other variables tested, including source of care, age, sex, duration of diabetes, presence of complications, and weight change, were not associated with metabolic control.
The strongest analysis of covariance model with demographic and medical-care variables accounted for 39% of the variance in metabolic control. The analysis suggests that other variables, possibly including several psychosocial variables, need to be assessed for their contribution to metabolic control.
Metabolic Control in Diabetic Subjects in Three Swedish Areas With High, Medium, and Low Sales of Antidiabetic Drugs
Authors: Stålhammar Jan , Bergman Ulf , Boman Kurt , Dahlén Magnus 
Published: March 2007

Objective
The relationship between use of antidiabetic drugs and metabolic control was studied in Swedish diabetic populations in areas with high (Gotland), medium (Tierp), and low (Skellefteå) sales of antidiabetic drugs.

Research Design and Methods
The study population consisted of 405 drug-treated diabetic subjects aged 50–74 yr. In all three areas, glyburide comprised ∼75% of the oral treatment.

Results
In accordance with sales, Gotland was found to be a heavy-use area, characterized by a high prevalence of insulin treatment (43%), combination therapy with sulfonylureas and biguanide (28%), and high prescribed daily doses (PDDs) of glyburide (15.5 ± 0.8 mg) compared with other areas. In Skellefteå, 38% were on insulin, 4% were on combination therapy, and the PDD of glyburide was 7.1 ± 0.6 mg. In Tierp, 27% were on insulin, 26% were on combination therapy, and the PDD of glyburide was 11.4 ± 0.7 mg. In Gotland, both men and women had significantly lower HbA1c levels, regardless of treatment mode, and a tendency to be more overweight compared with the area with the least pharmacological intensity (Skellefteå).

Conclusions
In the three diabetic populations, good metabolic control, defined as an HbA1c level of &lt; 7% and acceptable weight control (body mass index &lt; 27 for men and &lt; 25 for women), was achieved among only 16% in Gotland, 17% in Skellefteå, and 12% in Tierp.
Change in Metabolic Control and Functional Status After Hospitalization: Impact of Patient Activation Intervention in Diabetic Patients
Authors: Rost Kathryn M , Flavin Karen S , Cole Karen , McGill Janet B 
Published: March 2007

Objective
To determine whether a short intervention to enhance patient information seeking and decision making during hospitalization results in improved metabolic control and functional status in patients with diabetes mellitus.

Research Design and Methods
A randomized clinical trial was conducted in which control patients received a comprehensive 3-day evaluation and educational program, whereas experimental patients received a 45-min patient activation intervention and a 1-h self-administered booster in addition to the program. Metabolic control and functional status were measured at baseline and 4 mo postdischarge.

Results
During their discharge discussions, experimental patients asked significantly more questions than control patients (7.4 vs. 3.0, P &gt; .001) and 4 mo later reported significantly fewer physical limitations in activities of daily living than the control group (P = 0.02). Improvement in metabolic control was statistically significant only for experimental patients (P = 0.02), although their glycosylated hemoglobin levels were not significantly lower than control patients' at follow-up. The intervention did not diminish physician satisfaction with patient interactions, although it may have increased physician frustration with responsibilities that competed with patient care.

CONCLUSIONS
These results suggest that the addition of a patient activation intervention to a comprehensive diabetes management program may substantially enhance physical functioning among adults with diabetes mellitus.
Effect of Antihypertensive Drugs on Insulin Absorption
Authors: Veenstra Jan , van der Hulst Jan P , Wildenborg Ingrid H , Njoo Suzy F , Verdegaal Wim P , Silberbusch Joseph 
Published: March 2007

Objective
To examine the effects of antihypertensive drugs on the absorption of subcutaneously injected insulin.

Research Design and Methods
Eleven healthy volunteers (group 1) were given 1 mg/kg body wt propranolol three times a day during 48 h and a single dose on the morning of investigation. Seven other healthy volunteers (group 2) were given 10 mg nifedipine 30 min before subcutaneous injection of 10 U 125I-labeled soluble insulin. Absorption was measured by counting radioactivity externally. In both groups, control experiments were conducted under the same conditions without administration of propranolol or nifedipine.

Results
Propranolol usage was associated with higher mean percentages of remaining activity (P &lt; 0.05 by analysis of variance [ANOVA]) than in the control experiment. In the nifedipine experiment, mean percentages were significantly lower compared with the control experiment (P &lt; 0.02 by ANOVA). The mean decline in activity of all 30-min periods was 6.8 ± 3.5 vs. 3.6 ± 3.7% for control versus propranolol (group 1) (P &lt; 0.05) and 6.3 ± 1.8 vs. 9.6 ± 3.2% for control versus nifedipine (group 2) (NS).

Conclusions
Antihypertensive drugs can influence insulin absorption. Propranolol (a peripheral vasoconstrictor) decreases insulin absorption, whereas nifedipine (a vasodilatator) increases insulin absorption.
New Semiquantitative Dipstick Test for Microalbuminuria
Authors: Bangstad Hans-Jacob , Try Kenneth , Dahl-Jørgensen Knut , Hanssen Kristian F 
Published: March 2007

Objective
We compared a new semiquantitative dipstick test for microalbuminuria (Micral-Test) with a quantitative immunoturbidimetric method.

Research Design and Methods
This correlation study was performed at a pediatric and medical outpatient clinic at a university hospital. Overnight urine samples containing &lt; 200 mg/L albumin from 186 diabetic patients were analyzed.

Results
The correlation coefficient between the new semiquantitative method and the immunoturbidimetric reference method was 0.82. Elevated albumin concentration was defined as &gt; 20 mg/L albumin in overnight urine, and the prevalence of samples with values above this level was 28%. By this definition, the Micral-Test assay level &gt; or equal to 20 mg/L had a sensitivity of 92.3% and a specificity of 82.1%. Of the diabetic subjects, 84.9% were correctly classified as having elevated urinary albumin concentration or not.

Conclusions
The Micral-Test is useful for in-clinic screening for elevated urinary albumin concentration and monitoring the development of urinary albumin excretion in the low microalbuminuric range.
Comparison of Incidence of IDDM in Childhood Between Estonia and Finland, 1980–1988
Authors: Tuomilehto Jaakko , Podar Toomas , Reunanen Antti , Kalits Irina , Lounamaa Raisa , Tuomilehto-Wolf Eva , Adojaan Bela , Neff Barbara , LaPorte Ronald E 
Published: March 2007

Objective
To compare nationwide incidence of childhood insulin-dependent diabetes mellitus (IDDM) in children aged 0-14 yr between Estonia and Finland during 1980-1988. For Estonia, which has a population genetically and linguistically related to Finland, only limited information was available. Finland has the highest incidence of IDDM in the world.

Research Design and Methods
The registration of all new cases of IDDM in Estonia was conducted by the local district pediatricians who reported every newly diagnosed diabetic patient to the Republic Endocrinology Centre. Registration of all new cases of IDDM in Finland was based on the statistics of the Social Insurance Institution, which approves free-of-charge insulin treatment for diabetes. These data were validated with one or more additional data sources. The case ascertainment rate approached 100% in both countries.

Results
The average yearly incidence of IDDM standardized for age for the years 1980–1988 in Estonia was ~ 33% of that in Finland. Among males it was 11.3 (95% confidence interval [CI] 10.3–12.3) per 100,000 in Estonia and 35.1 (95% CI 33.4–36.9) per 100,000 in Finland, and among females 10.1 (95% CI 9.2–11.1) per 100,000 in Estonia and 30.4 (95% CI 28.8–32.1) per 100,000 in Finland. When the two periods 1980–1982 and 1986–1988 were compared, the age-standardized incidence in Estonia remained unchanged, whereas in Finland it increased ~ 20%.

Conclusions
The data between two populations who are ethnically and linguistically similar and live geographically close but in a different environment, provides further evidence that both genetic and environmental factors are contributing to the risk of IDDM.
Bacteremia in Adult Diabetic Patients
Authors: Leibovici Leonard , Samra Zmira , Konisberger Hanna , Kalter-Leibovici Ofra , Pitlik Silvio D , Drucker Moshe 
Published: March 2007

objective
To compare the microbiology, sources, complications, and outcome of bacteremia in diabetic and nondiabetic patients.

Research Design and Methods
A prospective study was conducted of all episodes of bacteremia in hospitalized diabetic and nondiabetic patients. The study consisted of patients ≥ 18 yr of age with bacteremia detected within a 19-mo interval.

Results
We compared 124 episodes of bacteremia in 119 diabetic patients to 508 episodes in 480 nondiabetic patients. Diabetic patients were older than nondiabetic patients (median age 74 vs. 68 yr, P = 0.0001). In patients with an indwelling urinary catheter and bacteremic urinary tract infection, the percentage of Klebsiella in diabetic patients was 60% (6 of 10) and in nondiabetic patients was 17% (4 of 23, P = 0.04). In patients without an obvious source of bacteremia, the percentage of staphylococcal isolates in diabetic patients was 29% (10 of 35) and in nondiabetic patients was 14% (24 of 176, P = 0.04). Staphylococci were a common cause of bacteremic infections of the extremities in diabetic patients (12 of 19, 63%) and nondiabetic patients (20 of 50, 40%). Septic shock was the only complication that was more common in diabetic patients. The mortality in diabetic and nondiabetic patients was 28 and 29%, respectively.

Conclusions
Our results represent elderly patients with non-insulin-dependent diabetes mellitus. In this group, empirical treatment for suspected bacteremic urinary tract infection in patients with a urinary catheter should include coverage for Klebsiella. Empiric treatment for suspected bacteremia of unknown origin or caused by infection of the extremities should include an antistaphylococcal drug. The prognosis of bacteremia in diabetic and nondiabetic patients was similar.
Lipoprotein(a) Levels in Black and White Children and Adolescents With IDDM
Authors: Levitsky Lynne L , Scanu Angelo M , Gould Samuel H. 
Published: March 2007

Objective
To examine the relationship between levels of lipoprotein(a) [Lp(a)], diabetes, and glycemic control in white and black nondiabetic control and insulindependent diabetic (IDDM) children and adolescents, fasting blood analyses were conducted on a subject sample drawn from referral-based diabetes and endocrine clinics and a primary-care general pediatric clinic.

Research Design and Methods
Thirty-six white and 16 black children with IDDM who volunteered to participate in this study were compared with 30 white and 42 black nondiabetic control children.

Results
Lp(a) protein levels were significantly higher (P &lt; 0.05) in both groups of black children compared with whites (black vs. white nondiabetic children 6.8 ± 0.95 vs. 3.1 ± 0.68 mg/dl and black vs. white diabetic children 7.5 ± 1.52 vs. 3.0 ± 0.64 mg/dl). Lp(a) protein levels directly correlated with the level of glycosylated hemoglobin (r = 0.46, P &lt; 0.01) in white diabetic children but not in black diabetic children. Well-controlled white diabetic children (n = 12, glycosylated hemoglobin &lt;10%) had a mean Lp(a) protein level of 1.4 ± 0.3 mg/dl compared with poorly controlled white diabetic children (n = 10, glycosylated hemoglobin &gt;13%) whose mean Lp(a) protein level was 5.7 ± 1 . 7 mg/dl (P &lt; 0.01).

Conclusions
We conclude that circulating levels of Lp(a) protein are increased in hyperglycemia. A genetically determined elevated level of Lp(a) is a risk factor for atherosclerotic disease in white and Asian adults. Elevated Lp(a) should be investigated as an independent risk factor for atherosclerotic disease in IDDM. It could prove to be an additional mechanism for the development of diabetic complications in selected populations.
Diagnosis of Gestational Diabetes in Early Pregnancy
Authors: Super Dennis M , Edelberg Stuart C , Philipson Elliot H , Hertz Roger H , Kalhan Satish C 
Published: March 2007

Objective
To determine whether glucose intolerance can be identified early in gestation in a high-risk population so that early intervention can be planned to prevent associated morbidity.

Research Design and Methods
After appropriate dietary preparation, patients with a high risk for gestational diabetes underwent a 50-g oral glucose screening test during fasting. Patients were tested on enrollment and every 10 wk until delivery. Those with a 1-h plasma glucose value of ≥7.5 mM underwent a 100-g oral glucose tolerance test. Gestational diabetes was based on either a markedly abnormal 50-g screening test or abnormal 100-g oral glucose tolerance test.

Results
Ten of 15 (66%) patients who developed gestational diabetes were diagnosed during the first half of the pregnancy. Six were diagnosed in the first trimester. If the definition of an abnormal 1-h plasma glucose value was lowered from 7.5 to 7.2 mM, an additional 2 patients could have been identified in the first trimester with an improvement in sensitivity from 70 to 91% with only a slight drop in specificity (from 91 to 88%). Diagnosis of gestational diabetes was not enhanced by measuring plasma insulin concentrations or insulin-glucose molar ratios.

Conclusions
The diagnosis of gestational diabetes in a high-risk population can be made in the first half of pregnancy. Early diagnosis should permit evaluation of intervention strategies, which may result in improved perinatal outcome.
Decrease of Lipoprotein(a) With Improved Glycemic Control in IDDM Subjects
Authors: Haffner Steven M , Tuttle Katherine R , Rainwater David L 
Published: March 2007

Objective
Recently, lipoprotein(a) [Lp(a)] has been identified as a major risk factor for coronary heart disease. There are few data available on the influence of metabolic control on plasma Lp(a) concentrations in subjects with insulin-dependent diabetes mellitus (IDDM), a group at high risk for coronary heart disease.

Research Design and Methods
We examined the effects of improved metabolic control on plasma lipid and lipoproteins and Lp(a) concentrations in 12 subjects before and after 21 days of tight metabolic control.

Results
Glycosylated hemoglobin declined from 8.4 to 6.9% (P &lt; 0.001), and Lp(a) declined from 29.7 to 27.1 mg/dl (P = 0.022). There were no significant differences in total, low-density lipoprotein, or highdensity lipoprotein cholesterol, although the decline in triglyceride concentrations were borderline statistically significant. The distribution of apolipoprotein(a) isoforms in IDDM patients was not unusual, and the apolipoprotein(a) isoform phenotypes did not change with improved metabolic control. Lp(a) concentrations were also significantly higher than in a population-based control group of nondiabetic subjects from the San Antonio Heart Study.

Conclusions
Although the number of subjects was small and the degree of improvement in metabolic control was modest, the results suggest that improved metabolic control may decrease the risk of coronary heart disease mediated by Lp(a) in IDDM.
Double-Blind Evaluation of Efficacy and Tolerability of Metformin in NIDDM
Authors: Dornan Timothy L , Heller Simon R , Peck Gillian M , Tattersal Robert B 
Published: March 2007

Objective
To test the efficacy and tolerability of metformin.

Research Design and Methods
An 8-mo double-blind placebo-controlled parallel-group trial was performed at University hospital diabetic clinics on 60 patients with non-insulin-dependent diabetes mellitus (NIDDM) treated by diet alone. Metformin was administered and built up to a maximum dosage of 1 g three times daily.

Results
Mean HbA1 fell from 11.7 ± 0.4 to 10.3 ± 0.4% (means ± SE) on metformin but rose from 11.8 ± 0.4 to 13.3 ± 0.4% on placebo (P &lt;0.001). Final mean fasting blood glucose was 5.1 mM lower with metformin than placebo (P &lt;0.001). No other biochemical variable differed significantly, and weight did not change. A favorable glycemic response was not restricted to the obese. The mean final dosage of metformin was 1.7 ± 0.1 g and was well tolerated.

Conclusions
Metformin achieved a 23% lower mean HbA1 than placebo without weight gain or significant unwanted effects.
Severe Hypoglycemia in Type I Diabetic Patients With Impaired Kidney Function
Authors: Mühlhauser Ingrid , Toth Gisela , Sawicki Peter T , Berger Michael 
Published: March 2007

Objective
To assess the frequency and possible risk indicators of severe hypoglycemia in insulin-dependent (type I) diabetic patients with impaired kidney function.

Research Design and Methods
Retrospective follow-up examination of case subjects and control subjects with mean follow-up periods of 2.9 and 1.3 yr, respectively. The setting was the diabetes center at the Düsseldorf University hospital. Subjects were consecutive type I diabetic patients. Case subjects consisted of 44 patients with initial serum creatinine levels of ≥133 μM and pathological proteinuria. Control subjects consisted of 46 patients with normal serum creatinine levels matched for age, duration of diabetes, and hypertension; 57% of case subjects and 67% of control subjects were being treated with p-blockers. Incidence of severe hypoglycemia (cases/patient-yr) was assessed through an interviewer-administered questionnaire.

Results
At comparable levels of HbA1c (7.9 ±1.8 vs. 7.6 ± 1.1%), case subjects had a fivefold higher incidence of severe hypoglycemic episodes (1.28 vs. 0.25 cases/patient-yr, P &lt;0.02) than control subjects. Within the group with impaired kidney function, patients with severe hypoglycemic episodes had lower HbA1c levels (7.4 ± 1.6 vs. 8.7 ± 2.0%, P &lt;0.03) and a lower body mass index (22.0 ± 3.4 vs. 24.4 ± 3.8 kg/m2 P &lt;han those without severe hypoglycemic episodes, whereas serum creatinine levels, body weight-related insulin dosage (U kg−1 day−1), prevalence of blindness, autonomic neuropathy, and treatment with β-blockers were comparable.

Conclusions
Type I diabetic patients with impaired kidney function are at an excessively high risk of severe hypoglycemia. In addition to low HbA1c levels, a low body mass index appears to be a risk indicator for this adverse effect of insulin therapy.
Glomerulopathy in Patient With Donohue Syndrome (Leprechaunism)
Authors: Ellis Eileen N , Kemp Stephen F , Frindik J Paul , Elders M Jocelyn 
Published: March 2007

Objective
To evaluate renal structure in a child with Donohue syndrome (leprechaunism), who at 10 yr of age was noted to have hypertension, microalbuminuria, and enlarged kidneys, a renal biopsy was performed.

Research Design And Methods
The renal biopsy tissue was evaluated by light and electron microscopy with standard stereological techniques to measure glomerular volume, glomerular basement membrane width, fractional mesangial volume, and peripheral capillary filtering surface density.

Results
On renal biopsy, there was a marked increase in glomerular volume, glomerular basement width, and mesangial volume, findings similar to those seen in patients with diabetic nephropathy.

Conclusions
This patient with marked insulin resistance associated with Donohue syndrome demonstrates renal and glomerular enlargement and morphometric glomerular changes similar to those seen in patients with diabetic nephropathy. In unusual syndromes with hyperglycemia and hyperinsulinemia, renal structural and functional changes typical of traditional diabetes mellitus may be seen.