bluuebunny/crossref_metadata_2025_split huggingface dataset:
The bone mineral density effects of calcitonin and alendronate combined therapy in patients with rheumatoid arthritis
Authors: OZORAN Kursat , YILDIRIM Murat , ÖNDER Mustafa , SIVAS Filiz , INANIR Ahmet 
Published: March 2007

AbstractAim  The bone mineral density (BMD) effects of calcitonin (CT) and alendronate (ALEN) therapy either alone or in combination were evaluated in patients with rheumatoid arthritis (RA).Method  Eighty out of 100 patients with RA using methotrexate 5–12.5 mg/week and prednisone 5–10 mg/day were included in the study. These were randomly divided into four groups: the first group was given ALEN 70 mg/week; the second was given 200 IU/day CT nasal spray; and the third group was given combined therapy of 70 mg/week ALEN and 200 IU/day CT nasal spray. The fourth group (control) as well as the other three groups were given 600 mg calcium and 400 IU vitamin D. Dual‐energy X‐ray absorptiometry BMD of lumbar, hip and forearm regions and laboratory investigations were performed before and at the 12th month of the therapy.Reuslts  Only the combined therapy group displayed significant decreases of alkaline phosphatase levels, pointing out that the high bone turnover seen in RA patients can only be normalized by combination therapy. Also the combined therapy group showed significant increases at the lumbar and hip regions, whereas at the forearm regions BMD values stabilized.Conclusion  We recommend the use of CT and ALEN combined therapy, especially in severe active cases of RA, but further prospective studies consisting of larger patient populations are needed to confirm the additive effects of this combined therapy on fracture risk in these patients.
The value of changes in CRP and ESR for predicting treatment response in rheumatoid arthritis
Authors: HEIDARI Behzad , HEIDARI Parham , TAYEBI Muhammad Ebrahim 
Published: March 2007

AbstractAim:  During treatment of rheumatoid arthritis (RA) the serum C‐reactive protein (CRP) and erythrocyte sedimentation rate (ESR) decrease concurrent with clinical improvement. The aim of this paper is to investigate whether changes of these parameters could predict treatment response.Methods:  Patients with active RA, requiring disease‐modyfying antirheumatic drugs were entered into the study. Serum CRP and ESR were assessed at baseline and 24 weeks after the treatment. Response to treatment was assessed by the RA Disease activity Score 28 (DAS28) and DAS28‐CRP response criteria. In statistical analysis the agreement between changes of CRP and ESR at the first stage of the treatment and DAS28/DAS28‐CRP were determined as ‘good’, ‘moderate’ and ‘none’ responses. The relationship between changes in CRP and DAS28‐CRP, ESR and DAS28 were also determined and compared.Results:  Sixty‐six patients with active RA entered the study. The mean age was 50 ± 18 years and the mean disease duration was 4.9 ± 5.8 years. After an average period of 24 weeks, 51 patients met the DAS28 and 49 patients met the DAS28‐CRP response criteria as good or moderate responders. Over the treatment period a reduction of serum CRP predicted 90% of DAS28‐CRP responders and reduction of ESR predicted 97% of DAS28 responders, whereas a lack of CRP or ESR reductions predicted 54% and 45% non‐responders, respectively. Overall, the accuracy of changes in CRP and ESR in predicting treatment response according to DAS28‐CRP and DAS28 response criteria were 77% and 73%, respectively. CRP/DAS28‐CRP was more sensitive but less specific than ESR/DAS28 in predicting treatment response.Conclusion:  Changes of CRP or ESR at the first stage of treatment can predict treatment response. Hence, measurement of serum CRP and ESR furnishes a reliable quantitative means for early anticipation of treatment response.
Season and activity of rheumatoid arthritis in Japan
Authors: SADAMOTO K. , OGAWA T. , OGURA T. , SAITO E. 
Published: March 2007

AbstractAim:  To investigate the relationship between rheumatoid arthritis (RA) activity and season.Methods:  Two hundred and eighty RA patients were asked whether they experienced any deterioration at different times of year. Each patient's RA activity was also recorded on medical charts.Results:  Sixty‐two percent of patients recognized seasonal deterioration. Spring and winter were common seasons of deterioration. From medical charts, there were two peaks of high deterioration. One peak was from April to June, and the other was from November to January.Conclusion:  Two‐thirds of RA patients felt deterioration related to season. Evaluation and notes of the deterioration pattern could support early appropriate therapy for RA patients.
Case series analysis of psoriatic arthritis: a two‐centre experience
Authors: MOHD SHAHRIR M. S. , EASHWARY M. , HESELYNN H. , MOHD SHAHDAN S. 
Published: March 2007

AbstractAim:  To provide the first case series analysis for psoriatic arthritis (PsA) in Malaysia.Methods:  Patient records were studied from rheumatology clinics in Universiti Kebangsaan Malaysia Hospital and Putrajaya Hospital in Malaysia.Results:  Thirty‐one patients from two rheumatology centres were studied. Thirteen patients (41.9%) were male and 18 patients (58.1%) were female. Nineteen patients (61.3%) were Malays, four (12.9%) were Chinese, seven (22.6%) were Indians and one (3.2%) was a Sikh. The majority of patients were in the > 50 years age‐group (11 [35.5%]) followed by the 41–50 years age‐group (10 [32.3%]). Thirteen patients (41.9%) had the disease since 41–50 years of age. Twenty‐three patients (77.4%) had no family history of PsA. Twenty‐three patients (74.2%) had psoriasis first, seven (22.6%) had arthritis first and one (3.2%) developed psoriasis and arthritis at the same time. Twenty‐four patients (77.4%) had positive activity correlation for skin and arthritis. The majority of patients had symmetrical arthritis (20 [64.5%]) and chronic plaque‐like lesions (22 [71.0%]). These patients were on NSAIDS and methotrexate (14 [45.2%]). One patient (3.6%) needed surgery for joint replacement.Conclusion:  Patients who were diagnosed as having PsA were Malays, age group of more than 50, disease onset at 41–50 years of age, no family history, had symmetrical and chronic plaque lesions, had psoriasis first and needed NSAIDS and methotrexate.
Serum mannose‐binding lectin (MBL) levels are decreased in gout patients
Authors: NALBANT Selim , ILHAN Abdullah , SOLMAZGUL Emrullah , ÖZYURT Mustafa , SAHAN Burak , KAPLAN Mustafa , DÝNCER Ümit 
Published: March 2007

AbstractObjective:  Mannose binding lectin (MBL) is a circulating plasma protein that plays a pivotal role in innate immunity. We aimed to investigate serum levels of MBL in patients with gout disease.Material and methods:  Mannose binding lectin levels were measured in sera of 38 patients with gout (study group; SG), 18 patients with other rheumatological diseases (patient controls; PC), and 24 healthy controls (HC) with ELISA.Results:  Patients with gout had significantly lower serum MBL levels compared to HC and PC (SG: 1948 ± 1361ng/mL vs. HC: 2793 ± 2567 ng/mL and PC: 2355 ± 1218, p = 0.01). No significant difference was observed in serum MBL levels for PC (p = 0.1). Low MBL levels (500 ng/mL) were present in a higher proportion of gout patients compared to HC (21%, 8/38 vs. 12%, 3/24, p = 0.03). Interestingly, the gout patients with low MBL levels (500 ng/mL) used alcohol every day.Conclusions:  Mannose binding lectin deficiency may contribute to the pathogenesis of gout patients.
Pulmonary haemorrhage and mesenteric vasculitis in a patient with systemic lupus erythematosus
Authors: ALKAABI J. K. , ELAGIB E. M. 
Published: March 2007

SummaryWE Report a 26‐year‐old female patient with systemic lupus erythematosus (SLE) who developed mesenteric vasculitis and pulmonary haemorrhage. This patient initially presented with an acute abdomen and extensive vasculitic rash. While she was being treated for her abdomen she developed fulminant pulmonary haemorrhage requiring mechanical ventilation. With supportive measures and aggressive immunosupression treatment she eventually made a complete recovery.
Hepatic vasculitis presenting with multiple sterile liver abscesses in a patient with systemic lupus erythematosus
Authors: WANGKAEW Suparaporn , LERTPRASERTSUK Nirush , CHOTIROSNIRAMIT Anon , LOUTHRENOO Worawit 
Published: March 2007

AbstractAlthough biochemical evidence of liver disease is common in patients with systemic lupus erythematosus (SLE), clinical liver disease is uncommon. We report on a 26‐year‐old woman who presented with acute febrile illness, right upper abdominal pain and multiple hypo‐dense lesions in the liver in a computed tomographic study that mimicked multiple liver abscesses. Multiple necrotizing hepatic granulomas and old occlusive hepatic arteritis were observed in the surgical liver specimen. She was later found to have SLE. This patient represented a rare case of SLE that had hepatic vasculitis with hepatic infarction mimicking multiple liver abscesses as an initial manifestation.
Bilateral avascular necrosis of both hips and both shoulders in a case with systemic lupus erythematosus: What should we blame, steroid or secondary antiphospholipid syndrome?
Authors: EMAD Y. , RAGAB Y. 
Published: March 2007

AbstractA 38‐year‐old female patient was diagnosed as a case of systemic lupus erythematosus (SLE) in 1994. Her initial presentation was nephritis which remitted on combination of steroid, azathioprine and pulse cyclophosphamide therapy. One year later the patient developed bilateral avascular necrosis (AVN) both hips and underwent bilateral hip replacement. In 2003 the patient developed bilateral AVN of both shoulders. In view of this uncommon presentation the patient screened for hidden secondary antiphospholipid syndrome and surprisingly investigations revealed negative anticardiolipin antibodies, weakly positive lupus anticoagulant test and positive reactivity against β2 glycoprotein 1. Although steroid is well know for its major role in AVN in patients with SLE, the presence of hidden secondary antiphospholipid syndrome augments the deleterious effects of steroid on bone and leads to AVN in uncommon sites. It is suggested that in SLE patients with positive lupus anticoagulant and negative antiphospholipid antibodies, testing for reactivity against β2 glycoprotein 1 is mandatory.
Macrosomic infants are not all equal
Authors: SINCLAIR Bronwyn Anne , ROWAN Janet Alison , HAINSWORTH Oliver Timothy 
Published: March 2007

AbstractAims:  To see whether macrosomic infants have different morbidity according to maternal screening results for gestational diabetes mellitus (GDM) and ethnicity.Methods:  After excluding infants of women with diabetes, the National Women's Hospital database identified 134 infants who were delivered in 2003 and weighed ≥ 4500 g. Case notes were reviewed to record risk factors for macrosomia, delivery details and neonatal morbidity. Outcomes were analysed according to screening results for GDM and compared between Polynesian and Asian women.Results:  Body mass index (BMI) was calculated in 29% of women, and GDM screening was undertaken in 51%. Infants of women who had a screening glucose < 7.2 mmol/L compared to ≥ 7.8 mmol/L had lower rates of admission to the neonatal intensive care unit (NICU) (6.4 vs 28.6%, P = 0.049), had less respiratory distress (3.2 vs 23.8%P = 0.033) and display a trend to less require intravenous dextrose (6.4 vs 23.8%P = 0.10). Maternal BMI was lower in Asian (26.5 ± 4.4 kg/m2) compared to Polynesian women (35.2 ± 8.1 kg/m2, P = 0.008). More Asian women had a Caesarean delivery (73.3 vs 25%P < 0.001) and their infants were more likely to be admitted to NICU (33.3 vs 7.7%P = 0.02), require intravenous dextrose (20 vs 1.9%P = 0.03) and have respiratory distress (26.7 vs 3.8%P = 0.02).Conclusion:  Risk factors for macrosomia are not assessed adequately, which may contribute to morbidity. Using a birthweight ≥ 4500 g to define macrosomia is associated with disparate morbidity between ethnicities that have different body compositions.
A customised birthweight centile calculator developed for an Australian population
Authors: MONGELLI Max , FIGUERAS Francesc , FRANCIS Andre , GARDOSI Jason 
Published: March 2007

AbstractCustomised percentiles improve the differentiation between constitutional and pathological smallness of the fetus and the neonate. We studied data from 12 420 pregnancies in Sydney to develop Australian coefficients for customised fetal growth and birthweight centiles. Significant coefficients were derived for maternal height, weight, parity and ethnic origin as well as gestational age and the baby's gender. Standardised comparison with results from previous reports from England and New Zealand shows marked similarities in the predicted birthweight at term, confirming international applicability of the concept of adjusting for constitutional factors when calculating the growth potential of an individual fetus.
Behavioral and psychological symptoms of dementia in untreated Alzheimer’s disease patients
Authors: HAMURO Atsushi , ISONO Hiroshi , SUGAI Yuichi , TORII Shigeo , FURUTA Nobuo , MIMURA Masaru , KAMIJIMA Kunitoshi 
Published: March 2007

AbstractBackground:  To ascertain the prevalence of psychotic symptoms and behavioral disturbances of dementia patients is useful for families and health care professionals in order to anticipate the progression of Alzheimer’s disease (AD) and to recognize deterioration. This study aimed to determine whether behavioral and psychological symptoms of dementia (BPSD) are related to severity of untreated AD.Methods:  Two hundred and two patients were classified into three groups by Functional Assessment Staging score as follows: mild group (n = 92) was at stages 3 or 4; moderate group (n = 80) was at stage 5; and severe group (n = 30) was at stages 6 or 7. We then compared the prevalence of BPSD among the groups. Psychiatric symptoms of BPSD were defined as including hallucinations, delusions, delusional misidentification syndrome and depressive mood; while behavioral disturbances included physical aggression, wandering, adverse sleep and hyperphagia.Results:  In our study, depressive mood, physical aggression and wandering were statistically associated with the severity of AD.Conclusion:  These results are meaningful for caregivers in helping them to understand the anticipated progression of AD and to recognize deterioration. In the care of AD patients, it is necessary to be aware of characteristics of each BPSD.
Socio‐psychological factors in suicide with Alzheimer’s disease: comparative case studies of two patients in the USA and Japan
Authors: KISHIKAWA Yusuke , FRIEDLAND Robert P. , UEDA Hideki , KITABAYASHI Yurinosuke , FUKUI Kenji 
Published: March 2007

AbstractThe objective of this case report is to illustrate the influence of socio‐psychological background on behavior in patients with Alzheimer’s disease (AD). A comparative analysis was undertaken of two suicide cases with AD in the USA and Japan. Both cases were in the early stages of AD. They succeeded in suicide even with their disturbed executive functions, because they felt deprived of their dignity for different reasons according to their socio‐cultural background. Early stage AD patients may retain the behavior and intellectual functions associated with their dignity and desire. Since dignity and desire are very cultural concerns, socio‐psychological background should be cautiously considered when dealing with the emotional problems of AD patients.
Marchiafava‐Bignami disease treated by mianserin hydrochloride in short‐term evaluated by neuropsychological analysis
Authors: FUKUMOTO Jun , SUZUKI Takeo 
Published: March 2007

AbstractSince 1903, Marchiafava‐Bignami disease has been recognized as a rare syndrome with focal demyelination and necrosis in the corpus callosum, which is usually found in chronic alcoholics. It extends into the neighboring white matter and occasionally as far as the subcortical regions. We report a Japanese patient with Marchiafava‐Bignami disease associated with alcohol abuse, who had traveled around Western Europe, North America and China for more than 30 years. As he suffered extreme delirium in the early stages we administered a low dose (10 mg) of mianserin hydrochloride. He was very irritable and uncooperative on admission, after 20 days his delirium had disappeared and his temper had become very calm and mild. After 40 days, his intelligence level increased substantially as measured by various neuropsychological tests.
Home‐based rehabilitation program for older adults with cognitive impairment: preliminary results
Authors: YAMAMOTO‐MITANI Noriko , MATSUOKA Keiko , FUJII Masako 
Published: March 2007

AbstractBackground:  While there is a growing interest in cognitive rehabilitation for older adults, not enough data is available regarding its feasibility and effectiveness in an older population. The present study implemented a home‐based cognitive rehabilitation program for older adults in order to explore the program’s feasibility and effectiveness.Methods:  The 8‐month rehabilitation program consisted of multiple workbooks targeted at improving attention, memory and executive function. Study participants worked on the workbooks at home with family members, while professional cognitive rehabilitation staff periodically evaluated their progress. Attention, memory and executive function were evaluated at outset, at month 4 and at the end of month 8.Results:  The nine initial participants had histories of subarachnoid hemorrhage or traumatic brain injury, or were outpatients of a memory clinic who had memory impairment. Six participants (66.7%) completed the 8‐month program; one subject intentionally withdrew from the program while two others withdrew due to hospitalization. Among the six remaining participants, attention improved significantly between the month 4 and month 8 evaluations, and between the initial and month 8 evaluations. Within subsets of the attention test, significant improvement was seen in the visual selective attention domain. There was no change in memory or executive function, as well as the subjective difficulties in daily lives.Conclusions:  This study suggests that a home‐based cognitive rehabilitation program for older adults is feasible and may improve attention, especially visual selective attention. An 8‐month rehabilitation program may have been of insufficient duration to generate significant improvements in memory or executive function.
Physical complications of dementia: 12 months research in a special ward for the elderly with senile dementia
Authors: UKAI Katsuyuki , MIZUNO Yutaka , OZAKI Kimihiko , SEKIYA Takahiro , TOMITA Kenji , ITO Takao 
Published: March 2007

AbstractBackground:  The Imaise Branch of Ichinomiya City Hospital proactively accepts patients with behavioral and psychological symptoms of dementia (BPSD). In cases with serious physical complications, we treat them in cooperation with other medical departments. We investigated the physical complications in our Special Ward for Elderly with Senile Dementia (WED) to determine the need to treat them for dementia.Methods:  The subjects were 53 patients, who left our WED in the 12 months from April, 2005 to March, 2006. We subdivided physical complications into three categories in this investigation: (i) serious emergencies occurring in WED with a possibly high risk of mortality; (ii) emergency complications arising in WED that required diagnoses and treatment by specialists of other departments; and (iii) chronic diseases related to other more severe diseases requiring treatment.Results:  The 53 investigated patients consisted of 28 men (53%) and 25 women (47%). Their average age was 79 years (male 76, female 82). There were 35 patients (66%) with Alzheimer’s disease, five (9%) with vascular dementia, two (4%) with dementia with Lewy bodies, and 11 with other illnesses. The average hospitalization period was about 8 months. Serious emergencies with a high risk of mortality occurred 22 times for every 15 patients (28%) in total. Six patients (11%) died in the WED. Emergencies requiring diagnoses and treatment by specialists of other departments occurred 23 times in every 18 patients (35%) in total. Patients with chronic diseases related to other more severe diseases numbered 26 (49%).Conclusion:  These investigations confirmed the great need to treat physical complications in facilities for patients with dementia. All three categories of physical complications showed high rates, and the kinds of diseases varied. It is necessary to diagnose and treat various physical complications with a high incidence rate, and it is important to cooperate with specialists of other medical departments.
Effect of oral hydration on skin microcirculation in healthy young and midlife and older adults
Authors: Wipke‐Tevis Deidre D. , Williams Donna A. 
Published: March 2007

ABSTRACTClinically undetected underhydration lowers subcutaneous tissue oxygen, impairs healing and increases wound infection. This study examined the effect of supplemental oral hydration on noninvasive measures of skin temperature (Ts), transcutaneous skin O2 (PtcO2), and CO2 (PtcCO2), and skin blood flow (laser Doppler fluxmetry [Flux]=concentration of moving blood cells [CMBC] × Velocity) in healthy adults. Nineteen Control and 18 Test (Hydrated) subjects participated. Ad libitum fluid intake was allowed before the experiment. Sensors were placed on the chest, lower legs, and feet. Time 1 resting supine Ts, PtcO2/PtcCO2, and Flux/CMBC/Velocity were obtained. Then, the Test group ingested 500 mL of H2O. Time 2 measures were obtained 30 minutes later. Data were analyzed using ANOVA. Change in Ts, PtcO2, PtcCO2, and Velocity did not differ between groups. Flux increased more in the Test than in the Control group (p<0.01). The Flux change was explained by a CMBC increase (p<0.05). For midlife/older subjects only, the CMBC change was greater in the Test than in the Control group (p<0.01). Flux may be sufficiently sensitive to detect microvascular changes in response to supplemental oral hydration. These data also suggest that subtle levels of hypoperfusion due to underhydration may exist in community‐dwelling healthy midlife/older adults in their natural state.
Painful leg ulceration: a prospective, longitudinal cohort study
Authors: Briggs Michelle , Bennett Michael I. , Closs S. José , Cocks Kim 
Published: March 2007

ABSTRACTThis study aimed to explore the relationship between pain mechanism, pain intensity, and leg ulcer characteristics using a 6‐month longitudinal cohort study in a community setting in the north of England. Patients with leg ulceration referred consecutively to district nurses were invited to participate (n=96). The main outcome measures were pain intensity using daily visual analogue scores, leg ulcer characteristics (etiology, size, location, duration), and LANSS (Leeds Assessment of Neuropathic Symptoms and Signs). Results suggested that type, duration, position, and size of the leg ulcer had no effect on average daily pain scores. Using the LANSS questionnaire, 43.5% of respondents reported symptoms suggestive of a neuropathic mechanism to their pain. Patients with neuropathic symptoms had higher average daily pain scores (p<0.001). Fewer people had healed ulcers at 6 months with neuropathic symptoms compared with those with no neuropathic symptoms (30.8 vs. 52.1%). It would seem that the severity of pain can not be predicted by the type, size, position, or duration of ulceration. Patients who scored positively for neuropathic symptoms had higher average daily pain scores and fewer had healed leg ulcers at 6 months compared with those who did not experience neuropathic signs and symptoms.