bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does a physician's specialty influence the recording of medication history in patients' case notes?
Authors: Yusuff Kazeem B. , Tayo Fola 
Published: April 2008

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Physicians undertake the documentation of medication history during clerking; where all the necessary information that guides the diagnostic and patient management tasks are obtained.• Medication histories documented by physicians are often incomplete and generally sketchy; however, the impact of a physician's specialty on the frequency and depth of medication history they document has not been studied. WHAT THIS STUDY ADDS • The depth and frequency of medication history documented by physicians is significantly influenced by their specialties.• Physicians appear more interested in documenting more frequently and in greater depth medication history information that appears to aid diagnostic tasks in their specific specialty.AIMSTo determine the impact of a physician's specialty on the frequency and depth of medication history documented in patient medical records.METHODSA cross‐sectional assessment of the frequency and depth of medication history information documented by 123 physicians for 900 randomly selected patients stratified across Cardiology, Chest, Dermatology, Endocrine, Gastroenterology, Haematology, Neurology, Psychiatry and Renal specialties was carried out at a 900‐bed teaching hospital located in Ibadan, Nigeria.RESULTSFour hundred and forty‐three (49.2%) of the cohort were males and 457 (50.8%) were females; with mean ages 43.2 ± 18.6 and 43.1 ± 17.9 years respectively. Physicians' specialties significantly influenced the depth of documentation of the medication history information across the nine specialties (P < 0.0001). Post hoc pair‐wise comparisons with Tukey's HSD test showed that the mean scores for adverse drug reactions and adherence to medicines was highest in the Cardiology specialty; while the Chest specialty had the highest mean scores for allergy to drugs, food, chemicals and cigarette smoking. Mean scores for the use of alcohol; illicit drugs; dietary restrictions was highest for Gastroenterology, Psychiatry and Endocrine specialties respectively. Physicians' specialties also significantly influenced the frequency of documentation of the medication history across the nine specialties (P < 0.0001).CONCLUSIONSPhysicians appear to document more frequently and in greater depth medication history information that may aid the diagnostic tasks in their specific specialty. Researchers and other users of medication history data documented in patients' medical records by physicians may want to take special cognizance of this phenomenon.
Genetic developments in autoimmune thyroid disease: an evolutionary process
Authors: Zeitlin Abigail A. , Simmonds Matthew J. , Gough Stephen C. L. 
Published: April 2008

SummaryThe identification of genes placing individuals at an increased risk for the development of autoimmune thyroid disease (AITD) has been a slow process. However, over the last 20 years or so real progress has been made with the mapping of novel loci, via a number of different approaches. First, through the use of traditional immunological methods, Human Leucocyte Antigen (HLA)/Major Histocompatibility Complex (MHC) was the first gene region to be associated with AITD and consistent replications have been reported. Second, the CTLA‐4 gene region on 2q33 was the first non‐MHC replicated locus to be primarily identified using the candidate gene method. Third, family‐based linkage studies led to the mapping of a new type 1 diabetes locus, the PTPN22 gene, which has subsequently been independently replicated as a susceptibility gene for Graves’ disease (GD). Fourth, despite many unsuccessful attempts at implicating the TSHR gene as a susceptibility locus for GD, a recent approach of ‘tagging’ all the common variation within the gene has led to its identification as the first GD specific locus. Moreover, the use of tag single nucleotide polymorphisms (SNPs) has also been used to implicate the recently identified type 1 diabetes locus, CD25 as a susceptibility gene for GD. Finally, large scale, ongoing genome‐wide association studies in multiple autoimmune diseases (AID) states, including AITD seem likely to lead to the identification of additional MHC and non‐MHC susceptibility loci.
The effect of growth hormone treatment on bone mineral density in prepubertal girls with Turner syndrome: a multicentre prospective clinical trial
Authors: Aycan Zehra , Cetinkaya Ergun , Darendeliler Feyza , Vidinlisan Sadi , Bas Firdevs , Bideci Aysun , Demirel Fatma , Darcan Sukran , Buyukgebiz Atilla , Yildiz Metin , Berberoglu Merih , Bundak Ruveyde 
Published: April 2008

SummaryBackground  Patients with Turner syndrome (TS) are treated with GH to increase adult height. Although it is well established that GH promotes longitudinal bone growth, the effects of GH treatment on bone density are less clear.Objective  To determine how GH treatment affects trabecular bone mineral density (BMD) in girls with TS at prepubertal ages in a prospective multicentre study.Patients and method  Twenty‐two patients with TS in the prepubertal period with a mean age of 9·8 ± 2·5 (range 3·6–12·8) years were included in the study. All girls with TS underwent measurement of areal BMD using dual‐energy X‐ray absorptiometry (DXA) to obtain pretreatment anteroposterior (AP) lumbar spine values at L1–L4. Patients received GH (Genotropin) subcutaneously for 1 year at a dose of 0·05 mg/kg/day. Height and weight were measured at 3‐monthly intervals. The AP lumbar spine areal BMD was remeasured using the same technique after 1 year of treatment. Lumbar spine BMD Z‐scores and volumetric BMD (vBMD) Z‐scores were calculated using national standards.Results  The height SDS of our cases showed a significant increase with GH therapy. The pretreatment lumbar spine (L1–L4) BMD Z‐score was –1·2 ± 1·2 SD and the vBMD Z‐score was –0·8 ± 1·6 SD. There were no significant changes in these values after 1 year of GH treatment. Prepubertal TS girls more than 11 years of age had lower vBMD Z‐scores (–1·7 ± 1·7 SD) than the girls aged less than 11 (–0·1 ± 1·0 SD) (P < 0·05) at the onset of therapy. No significant changes were observed in these values after 1 year of GH therapy.Conclusions  Osteopaenia becomes apparent in prepubertal TS patients as they reach pubertal age. BMD evaluation may be necessary in these prepubertal TS girls at diagnosis. Short‐term GH therapy in these TS patients does not have a significant effect on bone density when measured at a site with a predominance of trabecular bone.
Components of the metabolic syndrome predictive of its development: a 6‐year longitudinal study in Hong Kong Chinese
Authors: Cheung Bernard M. Y. , Wat Nelson M. S. , Tam Sidney , Thomas G. Neil , Leung Gabriel M. , Cheng Chun Ho , Woo Jean , Janus Edward D. , Lau Chu Pak , Lam Tai Hing , Lam Karen S. L. 
Published: April 2008

SummaryObjective  To investigate which of the components of the metabolic syndrome best predict its development.Design  Long‐term cohort of randomly selected adults.Patients  One thousand five hundred and forty‐eight subjects from the Hong Kong Cardiovascular Risk Factor Prevalence Study who did not have the metabolic syndrome by the US National Cholesterol Education Program (NCEP) or International Diabetes Federation (IDF) criteria at baseline.Measurements  Waist circumference, blood pressure, glucose, triglycerides and high‐density lipoprotein‐cholesterol (HDL).Results  After a median interval of 6·4 years, there were 219 and 143 new cases (21·9 and 14·3 per 1000 person‐years) of the metabolic syndrome by the NCEP and IDF criteria, respectively. The odds ratio for the NCEP metabolic syndrome was highest for low HDL, 4·08 [95% confidence interval (CI): 2·90–5·73] and that for the IDF metabolic syndrome was highest for central obesity, 5·94 [95% CI: 3·98–8·87]. Low HDL, found in 27·8% men and 34·3% women, had the highest sensitivity for the NCEP metabolic syndrome (48% in men and 57% in women) and the IDF metabolic syndrome (41% in men and 54% in women). Central obesity had the highest positive predictive values except that triglycerides had the highest positive predictive value for the NCEP metabolic syndrome in women. The areas under the receiver operator characteristic curve for waist circumference, triglycerides and HDL were similar. A model that included waist circumference and HDL predicted the metabolic syndrome as well as a model that included all five metabolic syndrome components.Conclusion  Obese Chinese adults should be periodically screened for the metabolic syndrome and have waist and HDL measurement.
Effect of variation in CYP11B1 and CYP11B2 on corticosteroid phenotype and hypothalamic–pituitary–adrenal axis activity in hypertensive and normotensive subjects
Authors: Freel E. M. , Ingram M. , Wallace A. M. , White A. , Fraser R. , Davies E. , Connell J. M. C. 
Published: April 2008

SummaryBackground  Aldosterone is important in the development of hypertension. We have shown that a single nucleotide polymorphism (SNP) (–344T) in the 5′ regulatory region (UTR) of the gene encoding aldosterone synthase (CYP11B2) associates with aldosterone excess and hypertension as well as altered adrenal 11‐hydroxylation efficiency (deoxycortisol to cortisol). This conversion is carried out by the enzyme 11β‐hydroxylase, encoded by the adjacent gene, CYP11B1. We proposed that the effects of CYP11B2 are explained by linkage disequilibrium (LD) across the CYP11B locus. We have demonstrated high LD across this locus and identified two SNPs in the 5′ UTR of CYP11B1 (–1859 G/T, –1889 A/G) that associate with reduced transcription in vitro and altered 11‐hydroxylation efficiency in vivo. Accordingly, we hypothesized that the reduced adrenal 11‐hydroxylation may lead to chronic resetting of the pituitary–adrenal axis, with chronically increased ACTH drive resulting in aldosterone excess.Methods  To test this, we examined hypothalamic–pituitary–adrenal (HPA) axis activity in hypertensive and normotensive individuals stratified according to genotype at CYP11B2 (–344T/C) and CYP11B1 (–1859 G/T, –1889 A/G). Fifty‐six subjects homozygous for CYP11B2 SNP (27 TT, 12 CC), and 38 homozygous for CYP11B1 SNPs (18 TTGG, 20 GGAA) were recruited. Diurnal variation and the effects of dexamethasone suppression and ACTH stimulation on plasma aldosterone, cortisol and ACTH under controlled conditions were studied.Results  Subjects with SNPs associated with reduced 11‐hydroxylation efficiency (–344T CYP11B2; TTGG CYP11B1) showed reduced inhibition of ACTH after dexamethasone (P = 0·05) and an altered cortisol–ACTH relationship (decreased cortisol–ACTH ratio, P < 0·02). The same individuals also demonstrated close correlations between plasma cortisol and aldosterone (–344T CYP11B2 r = 0·508, P < 0·004; TTGG CYP11B1 r = 0·563, P < 0·003) suggesting that there was common regulation (possibly ACTH) of these hormones in genetically susceptible subjects.Conclusions  Variation in CYP11B2 and CYP11B1 associates with chronic up‐regulation of the HPA axis. These novel data support the suggestion that chronic aldosterone excess, in genetically susceptible individuals, may be a consequence of increased ACTH drive to the adrenal and identify novel molecular mechanisms that may lead to the development of hypertension within the general population.
Pituitary adenomas in northern Sweden: a study on therapy choices and the risk of second primary tumours
Authors: Norberg Lars , Johansson Robert , Rasmuson Torgny 
Published: April 2008

SummaryObjectives  To present the incidence of pituitary adenomas in northern Sweden and to determine whether the incidence of second primary tumours differs from the incidence in the general population or might be related to radiotherapy.Design  A retrospective register study.Patients  A total of 546 patients with pituitary adenomas were identified in the Cancer Registry of northern Sweden between 1958 and 2004. Only patients with histopathological verification and/or endocrine activity of the adenoma and more than 12 months of follow‐up were included, resulting in 376 patients in the study.Measurements  The number of patients receiving surgery and/or radiotherapy and presenting second primary tumours were registered. Standard incidence ratios (SIRs) between the observed and the expected incidence of second primary tumours were calculated.Results  The total number of person‐years at risk for a second primary tumour was 4730. Fifty‐four out of 376 (14%) patients had 63 second primary tumours. Forty patients had second primary tumours diagnosed more than 12 months after diagnosis of the pituitary adenoma (expected 42·6, SIR 0·94, 95% CI 0·67–1·28). A significantly increased incidence of second primary tumours was seen in 42 men with GH‐secreting adenomas. Ten second tumours were found (expected 4·55, SIR 2·20, 95% CI 1·05–4·04). A total of 261 patients received radiotherapy and 31 second primary tumours occurred after radiotherapy (expected 32·9, SIR 0·94, 95% CI 0·64–1·34). Three second primary intracranial tumours appeared within the irradiation volume (expected 0·85, SIR 3·51, 95% CI 0·71–10·36).Conclusions  No significant increase was found in the incidence of second primary tumours in general in patients with pituitary adenomas. An increased incidence of second primary tumours was seen in men with GH‐secreting adenomas.
Preclinical cardiac involvement in phaeochromocytoma: a study with integrated backscatter
Authors: Galetta Fabio , Bernini Giampaolo , Franzoni Ferdinando , Tocchini Leonardo , Taurino Chiara , Bardini Michele , Rossi Marco , Salvetti Antonio , Santoro Gino 
Published: April 2008

SummaryObjective  It is well known that vascular and cardiac structure may be influenced by circulating neurohormonal factors. Our aim was to study the myocardial wall texture by integrated backscatter (IBS) analysis in patients with phaeochromocytoma (PHEO).Design  Fourteen patients with PHEO, 15 matched high‐normal blood pressure (BP) subjects, 15 mild essential hypertensives and 15 normotensive controls underwent two‐dimensional conventional ultrasonography and ultrasonic IBS of the myocardial wall. IBS analysis was performed at both interventricular septum and posterior wall levels. IBS values were expressed in decibels and corrected for the IBS values obtained within the pericardium (C‐IBS). The systo‐diastolic cyclical variations in IBS (CV‐IBS), an index of myocardial contractile performance, were also evaluated.Results  Patients with PHEO showed C‐IBS values comparable to those of hypertensive patients, and significantly higher than those of high‐normal BP subjects and controls at both septum and posterior wall levels (P < 0·001 for all). In PHEO patients, CV‐IBS was lower than that of normotensive, high‐normal BP subjects and hypertensive patients, at both septum and posterior wall levels (P < 0·001 for all). An inverse relationship was found in the PHEO group between 24‐h urinary normetanephrine and CV‐IBS of both septum (r2 = –0·29, P < 0·05) and posterior wall (r2 = –0·46, P < 0·05).Conclusions  Our results show that patients with PHEO have myocardial remodelling characterized by increased myocardial fibrosis, confirmed by an increase in the overall myocardial backscatter level measured. The observed decrease in the magnitude of CV‐IBS suggests an impairment of myocardial contractile performance. These results may provide insights into the role of catecholamines in left ventricular (LV) structure and function in PHEO.
Uncommon clinical presentations of pheochromocytoma and paraganglioma in two different patients affected by two distinct novel VHL germline mutations
Authors: Ercolino Tonino , Becherini Lucia , Valeri Andrea , Maiello Michele , Gaglianò Maria Sole , Parenti Gabriele , Ramazzotti Matteo , Piscitelli Elisa , Simi Lisa , Pinzani Pamela , Nesi Gabriella , Degl’Innocenti Donatella , Console Nico , Bergamini Carlo , Mannelli Massimo 
Published: April 2008

SummaryContext  The von Hippel‐Lindau (VHL) syndrome is an inherited multitumour disorder characterized by clinical heterogeneity and high penetrance. Pheochromocytoma (Pheo) is present in 10%–15% of cases and can be isolated or associated with other lesions such as haemangioblastomas, kidney cysts or cancer and pancreatic lesions. In VHL patients, Pheos generally secrete norepinephrine and are located in the adrenals. Extra‐adrenal Pheos (paragangliomas, PGLs) are rare.Objective  While performing genetic testing in patients affected by apparently sporadic Pheos or PGLs, we found two novel different VHL germline mutations in two females who presented with two distinct very uncommon clinical pictures. One patient was studied for the presence of an adrenal incidentaloma and the other for the presence of a neck tumour.Methods and results  Patients coding regions and exon–intron boundaries of RET (exons 10, 11, 13–15), VHL, SDHD, SDHB and SDHC genes were amplified and sequenced. We identified two novel VHL point mutations: a L198V missense mutation in a 32‐year‐old female affected by a right adrenal compound and mixed tumour constituted by an epinephrine secreting Pheo, a ganglioneuroma and an adrenocortical adenoma, and a T152I missense mutation in a 24‐year‐old female affected by a left carotid body tumour. No other lesions were found in the patients or in the VHL mutation positive relatives.Conclusions  These cases enlarge the list of VHL mutations and add new insights in the clinical variability of VHL disease, thus confirming the importance of genetic testing in patients affected by apparently sporadic Pheos or PGLs.
A prospective study on canine atopic dermatitis and food‐induced allergic dermatitis in Switzerland
Authors: Picco F. , Zini E. , Nett C. , Naegeli C. , Bigler B. , Rüfenacht S. , Roosje P. , Gutzwiller M. E. Ricklin , Wilhelm S. , Pfister J. , Meng E. , Favrot C. 
Published: April 2008

AbstractCanine atopic dermatitissensu strictoand food‐induced allergic dermatitis are common canine skin conditions, which are often considered clinically undistinguishable. Several attempts have been made to describe populations of atopic dogs and determine breed predisposition but the results were often biased by the use of hospital populations as control group. The present study aims to describe a population of Swiss atopic and food‐allergic dogs and to compare it with a data set representing more than 85% of all Swiss dogs. The study, which was carried out during 1 year in several practices and teaching hospital in Switzerland, describes a group of 259 allergic dogs, determines breed predisposition for atopic dermatitis and food‐induced allergic dermatitis, compares the clinical signs and features of both conditions, and outlines the clinical picture of five frequently affected breeds.
Evaluation of the anti‐inflammatory effect of infliximab in a mouse model of acute asthma
Authors: DEVECI Figen , MUZ M. Hamdi , ILHAN Nevin , KİRKİL Gamze , TURGUT Teyfik , AKPOLAT Nusret 
Published: April 2008

Background and objective: To evaluate the potential role of anti‐tumour necrosis factor (TNF)‐α mAb (infliximab) on the inflammatory response in a mouse model of acute asthma.Methods: BALB/c mice received intraperitoneal (i.p.) ovalbumin (OVA) on days 0 and 14, 100 μg of OVA intranasally on day 14 and 50 μg of OVA intranasally on days 25, 26 and 27. The low‐dose (2.5 mg/kg) and high‐dose (6.25 mg/kg) infliximab groups received i.p. infliximab before each i.p. sensitization and on challenge days 1, 6, 13, 20 and 27. The control group received i.p. injections of normal saline with alum on days 0 and 14 and normal saline without alum on days 14, 25, 26 and 27.Results: There were statistically significant decreases in the numbers of BAL fluid (BALF) neutrophils, eosinophils, as well as lung eosinophils in both the low‐ and high‐dose infliximab groups when compared with the control OVA sensitized/challenged group. The lower dose of infliximab did not alter lung neutrophil counts, but a marked decrease was seen with the high dose of infliximab. After treatment with low and high doses of infliximab, BALF levels of regulated on activation normal T cell expressed and secreted (RANTES), granulocyte macrophage‐colony stimulating factor (GM‐CSF), TNF‐α, IL‐6, macrophage inflammatory protein (MIP)‐2, and levels of RANTES, IL‐4, GM‐CSF, TNF‐α, IL‐6 and MIP‐2 in lung tissue were significantly decreased when compared with the control OVA sensitized/challenged group. There was a significant decrease in BALF IL‐4 only in the high‐dose infliximab group.Conclusions: These results show that an anti‐TNF‐α mAb has a considerable anti‐inflammatory effect on allergen‐induced lung inflammation in an animal model of acute asthma.
Common functional polymorphisms in the cathepsin S promoter in Japanese subjects: Possible contribution to pulmonary emphysema
Authors: MINEMATSU Naoto , NAKAMURA Hidetoshi , FURUUCHI Momoyo , NAKAJIMA Takahiro , TAKAHASHI Saeko , TSUJIMURA Shuko , TATENO Hiroki , ISHIZAKA Akitoshi 
Published: April 2008

Background and objective:  Cathepsin S is involved in the pathogenesis of COPD in murine models overexpressing interferon (IFN)‐γ and IL‐13. It is widely accepted that genetic factors partly influence susceptibility to COPD; however, the association of genetic polymorphisms in the cathepsin S gene with COPD has not been reported previously. In this study, functional polymorphisms in the 5′‐flanking region of the human cathepsin S gene were identified and their association with COPD phenotypes was investigated.Methods:  Genetic polymorphisms were detected by single strand conformation polymorphism analysis and direct sequencing. Genotypes and haplotypes were determined using amplification refractory mutation systems and single strand conformation polymorphism analysis. A promoter‐reporter assay was used to compare transcriptional activities between the haplotypes on stimulation with IFN‐γ. Haplotype analysis was performed on 204 smoking and 104 non‐smoking Japanese subjects.Results:  Four novel polymorphisms were detected in the 5′‐flanking region and three major haplotypes were identified. The haplotypes were associated with distinct promoter activities on stimulation with IFN‐γ and there was a trend indicating that higher transcriptional activity was linked to less pulmonary emphysema.Conclusion:  Novel functional polymorphisms were identified in the cathepsin S gene, which has a possible association with pulmonary emphysema in the Japanese population.
Neutrophil elastase activity in acute lung injury and respiratory distress syndrome
Authors: HASHIMOTO Satoru , OKAYAMA Yoko , SHIME Nobuaki , KIMURA Akio , FUNAKOSHI Yosuke , KAWABATA Kazuhito , ISHIZAKA Akitoshi , AMAYA Fumimasa 
Published: April 2008

Background and objective:  Neutrophil elastase (NE) may play a key role in the development of acute lung injury (ALI) or ARDS. NE activity (NEA) was measured in patients with ALI treated with a selective NE inhibitor.Methods:  NEA and NE‐α1‐antitrypsin (NE‐AT) complex were measured in plasma before, during and after the administration of the selective NE inhibitor, sivelestat, in 32 patients with a diagnosis of ALI or ARDS. NEA index (NEAI) was calculated as NEA/NE‐AT. The sequential organ failure assessment (SOFA) score and the ratio PaO2/fraction of inspired oxygen (FiO2) were measured.Results:  NEA and NE‐AT was raised in all patients. Sivelestat reduced NEAI and NEA (P < 0.01 for both) but not NE‐AT and NEA, and NEAI returned to pretreatment levels. NEA correlated closely with NE‐AT before, but not after treatment. No relationship was observed between these indices and SOFA score or PaO2/FiO2 ratio.Conclusions:  Sivelestat reduced NEA and NEAI in patients with ALI or ARDS suggesting NE inhibition. A larger study is needed to determine the relationship of NEA, NE‐AT and NEAI with the outcome of ALI/ARDS.