bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bone mineral density in patients with growth hormone deficiency: does a gender difference exist?
Authors: Hitz Mette Friberg , Jensen Jens‐Erik Beck , Eskildsen Peter C. 
Published: September 2006

SummaryObjective  The aim of the study was to clarify whether a gender difference exists with respect to bone mineral density (BMD) and bone mineral content (BMC) in adult patients with growth hormone deficiency (GHD).Design A case–control design.Methods Blood sampling for measurements of calcium, phosphate, creatinine, PTH, vitamin D, IGF‐1, markers of bone formation and bone resorption, and dual energy X‐ray absorptiometry (DEXA), to determine BMD and BMC of the lumbar spine, hip, distal arm and total body, were performed in 34 patients with GHD (19 females) and 34 sex‐, age‐ and weight‐matched healthy control subjects. The patients were well substituted on all pituitary axes, apart from GH.Results GH‐deficient males had significantly lower BMD in the lumbar spine (P = 0·02), hip (P = 0·01) and total body (P = 0·003) than healthy males while GH‐deficient females compared to healthy females had identical BMD values at all regions. This gender difference was even more obvious when BMD values were expressed asZ‐scores or as three‐dimensional BMD of the total body. The bone formation and bone resorption markers, as well as calcium and vitamin D, were all at the same levels in GH‐deficient and healthy males, indicating identical bone turnover. The GH‐deficient females, however, had significantly lower levels of bone markers compared to healthy females, indicating a reduced bone turnover. Oestrogen substitution of the GH‐deficient females could explain this difference.Conclusions Compared to healthy control subjects GH‐deficient males had, in contrast to GH‐deficient females, significantly reduced BMD and BMC. This obvious gender difference seems to be caused by the oestrogen substitution given to the females, compensating for the lack of GH, an effect testosterone does not seem to possess.
Expression of activin and inhibin subunits, receptors and binding proteins in Human adrenocortical neoplasms
Authors: Hofland J. , Timmerman M. A. , De Herder W. W. , Van Schaik R. H. N. , De Krijger R. R. , De Jong F. H. 
Published: September 2006

SummaryObjective  The growth and differentiation factors activin and inhibin can affect tumour formation and steroid production in the adrenal cortex. These factors bind to type I (Alk‐4), type II (ActRIIA, ActRIIB) and type III (betaglycan) receptors or to the activin‐binding protein follistatin. Expression of these activin‐related mRNAs was measured in different types of adrenocortical tissues and tumours to study the relationship with tumorigenesis.Design  Quantitative expression of activin‐related mRNAs was investigated in patient adrenocortical samples.Patients  Twenty‐eight human adrenocortical samples from normal and hyperplastic adrenals and from adrenocortical adenomas and carcinomas were collected after surgery for study purposes.Measurements  Using quantitative reverse transcription polymerase chain reaction (RT‐PCR), we investigated the expression of inhibin α‐, βA‐ and βB‐subunits, follistatin, betaglycan, ActRIIA, ActRIIB and Alk‐4 in the adrenocortical tissues. The expression of cytochrome P450c17 (CYP17) mRNA was also measured to investigate its association with inhibin and activin subunit expression.Results  All genes studied were expressed in all tissues, with the exception of the inhibin α‐subunit in one hyperplastic adrenal and three adrenocortical carcinomas. Expression of inhibin βA‐subunit, follistatin, betaglycan, ActRIIA, ActRIIB and CYP17 differed between nontumorous adrenals and carcinomas.Conclusions  These differences, together with correlation analysis, indicate parallel regulation of the expression of CYP17, the inhibin α‐subunit, ActRIIA, ActRIIB, betaglycan and follistatin. We conclude that the expression of activin and inhibin subunits, receptors and binding proteins is affected by tumour formation in the adrenal gland and may play a role in tumorigenesis.
Cutaneous squamous cell carcinoma metastatic to chronic lymphocytic leukaemia: diagnostic potential of fine needle aspiration cytology
Authors: Fležar M. Strojan , Prevodnik V. Kloboves , Kirbiš I. Srebotnik , Strojan P. 
Published: September 2006

Objective:  The phenomenon of cancer‐to‐cancer metastasis of cutaneous squamous cell carcinoma (SCC) and chronic lymphocytic leukaemia (CLL)/small lymphocytic lymphoma (SLL) is a rare event and only occasionally documented in the medical literature.Methods:  Two patients with SCC of the skin that were previously treated for CLL are presented. Both had palpable lymph nodes in the neck and fine needle aspiration cytology (FNAC) was performed to evaluate the pathological process. In addition, the literature on cutaneous SCC metastatic to CLL/SLL with special emphasis on the role of FNAC in this specific clinical situation was reviewed.Results:  On examination of the FNAC smear, cancer‐to‐cancer metastasis of cutaneous SCC to lymph node replaced by CLL was found. In one of the patients, light microscopy examination of the smear was complemented by immunostaining of atypical cells with cytokeratin antibodies and immunophenotyping of lymphoid cells by flow cytometry. In addition to our two patients, nine cases of cutaneous SCC metastatic to CLL/SLL have been reported in the literature, and in only one was the diagnosis made by FNAC.Conclusion:  FNAC supported by ancillary immunocytological techniques could also be used in diagnosis of specific clinical situations such as cancer‐to‐cancer metastasis of the tandem of SCC–CLL/SLL.
Comparative cytomorphology of skin, lymph node, liver and bone marrow in patients with lepromatous leprosy1
Authors: Singh N. , Bhatia A. , Lakra A. , Arora V. K. , Bhattacharya S. N. 
Published: September 2006

Objective:  The aim of this study was to compare the cytological changes in skin, lymph nodes, liver and bone marrow in patients with lepromatous leprosy.Methods:  Skin lesion, lymph node, liver and bone marrow aspirates were analysed. May–Grunwald–Giemsa (MGG) and Ziehl–Neelsen (Z–N) stains were employed. Comparative cytomorphology was studied.Results:  Twenty patients with lepromatous leprosy were studied. Lepra cells (LC) predominated in the skin aspirates of 12 patients with lepromatous leprosy (LL), lymphocytes accompanied LC in eight patients with borderline‐lepromatous (BL) leprosy. Three patients of LL leprosy and two of BL leprosy in type 2 reaction additionally had numerous neutrophils. Two patterns of lymph node aspirates were seen: partial replacement with few LC in a reactive lymphoid background (10), complete replacement with either only LC or LC in a background of degenerating neutrophils (10), the latter a feature of type 2 reaction. Liver aspiration was performed in seven patients and of bone marrow in eight patients. Occasional LC were present in five liver‐aspirated patients, steatosis and Kupffer cell hyperplasia in four patients, and myelopoiesis in two patients. Bone marrow smears invariably had occasional LC and a relative increase in mature plasma cells; sea‐blue histiocytes were seen in six patients.Conclusion:  Lepra cells predominated in skin and lymph node aspirates with complete replacement. In comparison, liver, bone marrow and lymph node aspirates with partial replacement were dominated by a preponderance of cells native to these organs with only few or occasional LC.
Ultrasound‐guided fine needle aspiration cytology in the diagnosis and management of thyroid nodules
Authors: Cai X. J. , Valiyaparambath N. , Nixon P. , Waghorn A. , Giles T. , Helliwell T. 
Published: September 2006

Objective:  To examine the accuracy of fine needle aspiration cytology (FNAC) in the diagnosis of thyroid nodules and compare the inadequacy rates for ultrasound‐guided and freehand FNAC.Methods:  A retrospective study of 434 patients with thyroid nodules who underwent diagnostic FNAC over a 2‐year period. Cytological diagnoses have been compared with the histological assessment of resection specimens in 69 cases.Results:  The inadequacy rate was significantly lower from ultrasound guided FNAC (24/373 cases, 6.4%) than from freehand FNAC (8/61 cases, 13.1%) (P = 0.043). Seventy‐six percentage of patients had a non‐neoplastic cytological diagnosis and, after multidisciplinary review, the patients were reassured and assigned to clinical follow‐up. Sixty‐seven patients had a resection for cytological appearances consistent with non‐neoplastic disease (n = 34), suspicious of follicular neoplasia (n = 23), or suspicious of malignancy (n = 10), and two patients had resections following inadequate cytology with ultrasound appearances suspicious of a neoplasm. The overall accuracy of FNAC analysis for malignancy was 97.0%, with sensitivity 83.3%, specificity 98.0%, positive predictive value 71.4% and negative predictive value 98.4%. The overall accuracy of FNAC analysis for the prediction of neoplasia was 97.5%, with sensitivity 80.5%, specificity 97.8%, positive predictive value 89.2% and negative predictive value 95.9%. Difficulties in cytological diagnosis were associated with lymphoid infiltrates and with degenerative changes in follicular adenomas.Conclusion:  Ultrasound‐guided FNAC has a significantly lower yield of inadequate aspirates than palpable FNAC. The ability of FNAC to predict neoplasia in 89% patients and to exclude neoplasia in 95.9% patients makes an important contribution to the multidisciplinary assessment of patients.
Fine needle aspiration cytology: a survey of current European practice
Authors: Kocjan G. , Feichter G. , Hagmar B. , Kapila K. , Kardum‐Skelin I. , Kloboves V. , Kobayashi T. K. , Koutselini H. , Majak B. , Schenck U. , Schmitt F. , Tani E. , Totch M. , Onal B. , Vass L. , Vielh P. , Weynand B. , Herbert A. 
Published: September 2006

AbstractFine needle aspiration cytology (FNAC) is practised widely throughout Europe. The majority of countries have dedicated cytopathologists as well as histopathologists practicing cytology. Despite this, FNAC is performed mostly by clinicians and radiologists except in the larger centres with dedicated staff with a special interest in cytopathology. The advent of One‐Stop diagnostic services and image‐guided procedures are prompting further development of FNAC clinics where cytopathologists take their own samples, issue reports in the same clinical session and take extra material for ancillary tests to complete the diagnosis. The volume of FNAC work varies accordingly; in dedicated centres FNAC represents up to 80% of the workload whilst, in the majority of countries, it represents one quarter or less. Hence, the rate of inadequate FNAC varies widely, depending on the local sampling policies and the organ, but does not exceed 25% in any of the countries. The most sampled organs are breast and thyroid, followed by lymph nodes. Most countries have dedicated training in cytopathology for pathology trainees, the duration varying between 6 months and 2 years of the total training time. This discussion, focusing on European practices, highlights the heterogeneity of FNAC activity but also its success in many centres where it is practiced to a high standard, particularly in breast, thyroid and lymph node pathology. The relatively high rate of inadequate material in some centres reflects local policies and calls for greater uniformity of FNAC practice, particularly specimen sampling. To achieve this, the future direction should concentrate on specialist training, to include performing as well as interpreting FNAC, as part of the curriculum. Current emphasis on web‐based training may not provide first hand experience of the FNAC procedure and should be supplemented by attending FNAC clinics and developing the technique to its full potential.
One year follow‐up of overweight and obese hypertensive adults following intensive lifestyle therapy
Authors: Jehn M. L. , Patt M. R. , Appel L. J. , Miller E. R. 
Published: September 2006

AbstractObjective  To examine the long‐term effect on weight maintenance and dietary habits of participants in a clinical trial for weight loss.Setting  Community‐based residents living in Maryland.Participants  Forty‐four hypertensive, overweight adults who participated in a randomized clinical trial of weight loss. Participants were randomized to an intensive ‘lifestyle’ intervention or a ‘monitoring’ group.Main outcome measures  Weight, self‐reported current intake of fat and fruit/fibre and self‐reported barriers to maintain weight loss were assessed 1 year after the completion of the Diet, Exercise and Weight‐loss Intervention Trial (DEW‐IT) trial.Analysis  t‐tests were used to compare groups for differences in continuous variables and chi‐square tests were used to compare groups for categorical variables.Results  Fourty‐two of the 44 DEW‐IT subjects participated in the follow‐up study. Overall, 55% (12/19) of the lifestyle intervention group remained at or below their baseline weight at 1 year, compared with 48% (11/23) of the monitoring group (P = 0.32). However, during that year, 95% (18/19) of the lifestyle intervention group and 52% (12/23) of the monitoring group gained weight from the end of the study. Both groups reported similar intake of fruits/vegetables (servings day−1), dietary fibre (g day−1) and fat (g day−1).Conclusions and implications  The majority of participants who lost weight during the trial regained weight during the course of 1 year. A successful intensive 2‐month programme of lifestyle modification (DEW‐IT) was ineffective for long‐term maintenance of weight loss.
The impact of percutaneous endoscopic gastrostomy feeding upon daily life in adults
Authors: Brotherton A. , Abbott J. , Aggett P. 
Published: September 2006

AbstractBackground  The provision of home enteral tube feeding in adults has increased in the UK. This study explored how percutaneous endoscopic gastrostomy (PEG) feeding impacts on daily lives of adult patients, from the patients’ and carers’ perspectives.Methods  A semi‐structured interview approach was developed to obtain participants’ views of the impact of living with a PEG. A cross‐sectional qualitative purposive sampling design was employed. Thirty‐four semi‐structured interviews were conducted (15 adult patients and 19 carers) and data were analysed descriptively and thematically.Results  Difficulties arising from PEG feeding included vomiting, diarrhoea, infection of the PEG site and leakage. The key issues that emerged included relief of pressure to consume an oral diet, disturbed sleep, restricted ability to go out, restricted choice of clothing, difficulties finding a place to feed, missing being able to eat and drink, social occasions, negative attitudes of others towards feeding and the burden placed on family members.Conclusions  The key themes that emerged from participants were diverse and highlight a need for increased social support for both patients and their carers, planned on an individual basis.
Acculturation and education level in relation to quality of the diet: a study of Surinamese South Asian and Afro‐Caribbean residents of the Netherlands
Authors: Nicolaou M. , Van Dam R. M. , Stronks K. 
Published: September 2006

AbstractBackground  To consider the changes in overall diet quality following migration we examined the associations of acculturation variables and education level with diet in Surinamese South Asian and Surinamese Afro‐Caribbean origin on the one hand, and ethnic Dutch residents of the Netherlands on the other. Surinam is a former Dutch colony in South America.Methods  We randomly selected men and women aged 35–60 years: ethnic Dutch, n = 552; South Asian, n = 306; Afro‐Caribbean, n = 660. Intakes of fruit, vegetables, red meat, fish, vegetable oils, breakfast and salt were measured using a short questionnaire that formed the basis for a ‘diet quality indicator’ score. Highest education was measured and acculturation of the Surinamese groups was assessed by age at migration, number of resident years and a scale measure of social contacts with ethnic Dutch.Results  Compared with ethnic Dutch, both Surinamese groups scored higher on overall diet quality (P ≤ 0.001) but some aspects of diet (breakfast and salt use) were less prudent. Education was positively associated with diet quality in ethnic Dutch (P ≤ 0.01), but not consistently so in Surinamese. Associations with social contact with ethnic Dutch varied for different quality aspects of the diet. Residence duration (mean = 22 years) and age at migration (mean = 21 years) were not associated with diet.Conclusions  A greater degree of acculturation does not necessarily lead to a less healthful diet in migrants. In addition, the association of education level with diet may differ for migrant groups.The diet of migrants differ from host populations, suggesting that migrant groups should be considered in the development of nutrition health promotion activities.
Effectiveness of written guidelines on the appropriateness of thromboprophylaxis prescriptions for medical patients: a prospective randomized study
Authors: FONTAINE A. , MAHÉ I. , BERGMANN J. F. , FIESSINGER J. N. , DHOTE R. , COHEN P. , VINCENEUX P. 
Published: September 2006

Abstract.Objective.  To assess the effectiveness of providing doctors with written thromboprophylaxis prescription aids based on current recommendations.Design.  A prospective trial of specific anticoagulant prescription forms: a 1‐day survey before and after the intervention in each centre.Setting.  30 Internal Medicine departments of Assistance Publique‐Hôpitaux de Paris.Subjects.  All inpatients were included, except those who were either admitted or discharged on the day of the survey, and those receiving curative anticoagulant treatment.Interventions.  The study included three parts: (i) a 1‐day baseline survey; (ii) over the following 3‐month period, departments were randomized into two groups: all practitioners in wards allocated to the intervention group were required to systematically use specific anticoagulant prescription forms, whilst doctors in the control group continued prescribing according to their usual practices and (iii) a 1‐day postintervention survey. Main outcome measure.  The proportion of prescriptions in accordance with the recommendations.Results.  1469 patients were included. The intervention produced a significant reduction in the frequency of over‐prescriptions, from 25% to 14% of the patients who did not meet the guideline criteria (adjusted OR: 0.3; 95% CI: 0.1–0.8). Using specific forms did not improve under‐prescription of anticoagulants. A little over 60% of the patients who met guideline criteria for thromboprophylaxis were prescribed anticoagulants in both intervention and control wards, either at baseline or after intervention.Conclusions.  Multitargeted interventions using a variety of means and strategies should still be considered to improve prescriptions that may have a significant impact on health expenses and, most importantly, on patients outcomes.
Evaluation of a primary care‐oriented brief counselling intervention for obesity with and without orlistat
Authors: POSTON W. S. C. , HADDOCK C. K. , PINKSTON M. M. , PACE P. , REEVES R. S. , KARAKOC N. , JONES P. , FOREYT J. P. 
Published: September 2006

Abstract.Objective.  There is a significant need for an obesity treatment model suitable for the primary care environment. We examined the effectiveness of a brief counselling intervention alone, in combination with orlistat, and drug‐alone in a 12‐month randomized‐clinical trial at a medical school obesity centre.Methods.  Participants (N = 250) with body mass index (BMI) ≥27 were randomized. Changes in body weight, lipids, blood pressure and serum glucose were examined. Drug adherence and attendance were also evaluated.Results.  Completers analysis was conducted on 136 participants with data at baseline, 6 and 12 months and intention‐to‐treat analyses (ITT) for the total sample. Amongst completers, participants in the drug only (P = 0.012) and drug + brief counselling (P = 0.001) groups lost more weight (mean ± SD: −3.8 ± 5.8 kg and −4.8 ± 4.4 kg, respectively) than participants in the brief counselling only group at 6 months (−1.7 ± 3.3 kg), but there were no significant group differences at 12 months. ITT model results were similar to completers at 6 months and remained significant at 12 months, but the weight losses were more modest (<3 kg) for both groups receiving orlistat. For brief counselling alone, participants gained weight (1.7 ± 4.2 kg). Cardiovascular disease (CVD) parameter changes were negligible.Conclusions.  Pharmacotherapy alone or combined with brief counselling resulted in modest weight losses that had minimal impact on cardiovascular parameters, but were greater than brief counselling alone. Whilst brief interventions and primary pharmacotherapy have been suggested as viable treatments for implementation in primary care settings, our study suggests that such minimal interventions provide minimal benefits.
Identification and characterization of receptors for vacuolating activity of subtilase cytotoxin
Authors: Yahiro Kinnosuke , Morinaga Naoko , Satoh Mamoru , Matsuura Gen , Tomonaga Takeshi , Nomura Fumio , Moss Joel , Noda Masatoshi 
Published: September 2006

SummarySome shiga toxin‐producing Escherichia coli secrete a novel AB5 cytotoxin, named subtilase cytotoxin (SubAB), which induces vacuole formation in addition to cytotoxicity in susceptible cells. By immunoprecipitation with SubAB from Vero cells, we discovered proteins of 100 kDa, 135 kDa and 155 kDa as potential candidates for its receptor. These proteins were N‐glycosylated in their extracellular domains, a modification that was necessary for interaction with SubAB. Biotinylated receptors were partially purified by Datura stramonium agglutinin affinity chromatography and avidin‐agarose and analysed by TOF mass spectroscopy. The peptide sequences of p135 were identical to β1 integrin, and its identification was confirmed with anti‐integrin β1 antibody. The p155 protein was identified as α2 integrin using anti‐integrin α2 antibody. In addition, treatment of Vero cells with β1 integrin RNAi before exposure to SubAB prevented vacuolating activity. These results suggested that SubAB recognizes α2β1 integrin as a functional receptor; this first interaction may be an important key step leading to the SubAB‐induced morphological changes in Vero cells.
Defining the Mga regulon: comparative transcriptome analysis reveals both direct and indirect regulation by Mga in the group A streptococcus
Authors: Ribardo Deborah A. , McIver Kevin S. 
Published: September 2006

SummaryThe regulator Mga in the group A streptococcus (GAS) is known to directly activate several virulence genes important for colonization and immune evasion. Transcriptome analysis comparing two mga‐1 serotypes (M1 SF370, M6 JRS4) and one mga‐2 serotype (M4 GA40634) against their isogenic mga‐inactivated strains uncovered a broader Mga regulon profile containing both activated and repressed genes with predicted functions primarily related to sugar metabolism. This was reflected in the altered abilities of M1 and M4 Mga mutants to grow in chemically defined media with a single sugar source compared with their wild‐type counterparts. Although the M1 and M4 Mga profiles were similar, the M6 JRS4 was clearly distinct, even from other M6 strains. Real‐time RT‐PCR and Northern blots confirmed that established core Mga regulon genes directly activated by Mga (emm, scpA, sof, fba) exhibited the highest activation levels across all strains tested. Spy2036 encoding a cytosolic hypothetical protein was highly activated in all three serotypes and was called gene regulated by Mga (grm). Mga bound directly to Pgrm, which overlaps the Mga‐regulated Psof in OF+ strains, suggesting that grm is part of the core Mga regulon and Mga is able to activate divergently transcribed genes from a single site. Furthermore, Mga activated speB when detectable in the wild‐type strain, although direct binding of Mga to PspeB could not be demonstrated. Thus, Mga is able to both directly and indirectly regulate genes shown to be important for virulence and the metabolic homeostasis of GAS.