bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prostate‐specific antigen changes and prostate cancer in hypogonadal men treated with testosterone replacement therapy
Authors: Coward Robert M. , Simhan Jay , Carson III Culley C. 
Published: December 2008

OBJECTIVESTo retrospectively review hypogonadal men receiving testosterone replacement therapy (TRT), and evaluate the changes in prostate‐specific antigen (PSA) levels over an extended period, and thus evaluate the occurrence of prostate cancer, as a primary concern in treating late‐onset hypogonadism (LOH) is the potential increased risk of prostate cancer; we also recorded the cardiovascular effects of TRT.PATIENTS AND METHODSIn all, 81 hypogonadal men (mean age 56.8 years) were followed for a mean (range) of 33.8 (6–144) months after starting TRT. All men had a normal baseline PSA level before TRT and had routine laboratory investigations, including measurements of body mass index (BMI), haematocrit, lipid profile, and liver function tests (LFTs). Testosterone and PSA levels were assessed every 6–12 months. Patients with a biopsy‐confirmed or recent history of prostatitis before treatment were excluded. TRT was discontinued in men who developed prostate cancer.RESULTSBefore and 36 months after treatment the total testosterone levels were 241.1 and 379.8 ng/dL (P < 0.05), respectively. Four men (4.9%) developed prostate cancer at a mean (range) of 32.5 (22–41) months after starting TRT. In men without prostate cancer (95.1%), PSA levels did not increase significantly at 1‐year intervals for 5 years. There was no statistical difference in PSA level change from baseline to 36 months when patients without prostate cancer were stratified into groups according to age (≤50, 55–65 and ≥70 years). In men with prostate cancer there was an increase in mean PSA level from baseline to 18 months of 1.8 ng/mL, and to 36 months of 3.2 ng/mL (P < 0.05). Total cholesterol improved from 203.8 to 166.6 mg/dL (P < 0.05) after 36 months of TRT; the BMI, haematocrit and LFTs did not change significantly.CONCLUSIONSLOH is an increasingly prevalent disease characterized by a symptomatically low testosterone level, and TRT is effective in normalizing serum testosterone levels, providing a beneficial cardiovascular effect, and improving sexual function and overall quality of life. PSA levels remain stable after normalization of testosterone for ≥5 years, prostate cancer can be effectively diagnosed and treated in men taking TRT, and the incidence of prostate cancer among men with LOH on TRT is no greater than that in the general population.
Does a history of previous surgery or radiation to the prostate affect outcomes of robot‐assisted radical prostatectomy?
Authors: Martin Aaron D. , Desai Premal J. , Nunez Rafael N. , Martin George L. , Andrews Paul E. , Ferrigni Robert G. , Swanson Scott K. , Pacelli Anna , Castle Erik P. 
Published: December 2008

OBJECTIVETo evaluate retrospectively whether or not previous treatment to the prostate alters the perioperative outcomes from robot‐assisted radical prostatectomy (RARP) after the initial ‘learning curve’, as there are conflicting data on outcomes of RP in patients with previous treatment to the prostate.PATIENTS AND METHODSWe retrospectively reviewed the charts of patients who had RARP between March 2005 and August 2007, and analysed demographic, perioperative variables and pathological data. In all, 510 patient charts were reviewed, identifying 24 patients with a history of previous treatment to the prostate including transurethral resection or incision of the prostate, transurethral microwave therapy, transurethral needle ablation, photoselective vaporization, simple prostatectomy, external beam radiotherapy, brachytherapy, and open bladder neck reconstruction (group 1) and 486 with no previous treatment (group 2).RESULTSThere was no significant difference between the groups in body mass index, clinical stage, grade or prostate volume, but the patients in group 1 were older (70 vs 65 years, P = 0.001). Outcome analysis comparing groups 1 and 2 showed an estimated blood loss of 155 vs 137 mL, length of hospital stay of 2.2 vs 1.5 days, operative duration of 200 vs 186 min and catheter time of 12 vs 8 days, respectively; only the last was statistically significant (P = 0.03). There was an 8.3% and 6.8% complication rate in groups 1 and 2, respectively, and the respective overall positive margin rate was 20.8% and 22.6%.CONCLUSIONSA history of previous treatment of the prostate does not appear to compromise the perioperative outcomes of RARP.
The results of concurrent chemo‐radiotherapy for recurrence after treatment with bacillus Calmette‐Guérin for non‐muscle‐invasive bladder cancer: is immediate cystectomy always necessary?
Authors: Wo Jennifer Y. , Shipley William U. , Dahl Douglas M. , Coen John J. , Heney Niall M. , Kaufman Donald S. , Zietman Anthony L. 
Published: December 2008

OBJECTIVESTo report our original experience in patients in whom bacille Calmette‐Guérin (BCG) therapy has failed for T1 bladder cancer with subsequent progression to T2 disease treated with chemo‐radiotherapy, as the management of recurrent high‐grade T1 bladder cancer after failed BCG therapy is challenging, and radical cystectomy is the standard treatment because there are no well established second‐line bladder‐preserving therapies.PATIENTS AND METHODSFrom 1988 to 2002, 18 patients with T2 recurrence after failure of BCG therapy for T1 bladder cancer were treated with chemo‐radiotherapy at the authors’ institution. Patients received a visibly complete transurethral resection of the bladder tumour (TURBT) and concurrent chemo‐radiotherapy with a mid‐treatment evaluation after 40 Gy. Patients with less than a complete response had a prompt cystectomy; the others completed radiotherapy to 64–65 Gy. The primary treatment outcome was freedom from cystectomy due to recurrence not treatable by conservative measures; secondary outcomes included disease‐specific (DSS) and overall survival (OS).RESULTSWith a median follow‐up of 7.0 years, only one patient had persistent tumour at re‐staging TURBT and had an immediate cystectomy. Of the remaining 17 patients, 10 (59%) were free of any bladder recurrence. The actuarial 7‐year DSS and OS were 70% and 58%, respectively. At 7 years, 54% of patients were alive with intact bladders and free of invasive recurrence.CONCLUSIONSIn this study we specifically evaluated patients with apparently small muscle‐invasive recurrences after BCG treatment for T1 bladder cancer. Selective bladder preservation with chemo‐radiotherapy is possible, with low morbidity and a high chance of long‐term bladder control. If successful in treating T2 recurrences after BCG therapy, it now seems timely to critically evaluate chemo‐radiotherapy as an alternative to immediate cystectomy in the management of patients with T1 recurrences after BCG.
Obesity in the Iranian population
Authors: Rashidy‐Pour A. , Malek M. , Eskandarian R. , Ghorbani R. 
Published: December 2008

SummaryThere is an obesity epidemic worldwide, which has been increasing in recent years. An epidemiologic cross‐sectional study was conducted among 3799 persons who were 30–70 years old in Semnan Province, Iran. Multistage cluster sampling was performed, and subjects were selected from urban and rural populations. Body weight, height and waist circumference (WC) were measured, and body mass index (BMI) and waist to hip ratio (WHR) were calculated. Overweight and obesity were defined as 25 ≤ BMI < 30 and ≥30 respectively in men with WHR ≥ 0.9 or WC ≥ 102 cm, and women with WHR ≥ 0.8 or WC ≥ 88 cm were considered centrally obesite. Prevalence of obesity and overweight was 26.3% and 40.6% respectively. Prevalence of obesity was more among women (39.5%) than men (14.5%) with central obesity prevalence using WHR and WC cut‐points of 72.2% and 26.6% respectively. There was a significant association between obesity and age, gender, residential area and educational level (P < 0.01). In conclusion, prevalence of obesity and overweight among 30–70 years old, especially among women, was higher than expected. A comprehensive educational programme on obesity risk factors and obesity‐related diseases is necessary.
Obesity as an independent risk factor for elective and emergency caesarean delivery in nulliparous women – systematic review and meta‐analysis of cohort studies
Authors: Poobalan A. S. , Aucott L. S. , Gurung T. , Smith W. C. S. , Bhattacharya S. 
Published: December 2008

SummaryThe objective of the study was to investigate the association between increasing maternal body mass index (BMI) and elective/emergency caesarean delivery rates. Systematic review and meta‐analysis of published cohort studies were used. The bibliographic databases, MEDLINE, EMBASE, CINAHL, were searched systematically, with no language restrictions, from 1996 to May 2007. MeSH terms and key words for ‘pregnancy’, ‘obesity’, ‘overweight,’‘body mass index’ and ‘caesarean section’ were combined with the Cochrane Collaboration strategy for identifying primary studies. Finally, 11 papers were considered eligible for inclusion in the review. Although all the papers were cohort studies, only three were prospective in nature. Compared with women with normal BMI (20–25 kg m−2), the crude pooled odds ratios (95% confidence intervals) for caesarean section in overweight (BMI 25–30 kg m−2), obese (BMI 30–35 kg m−2) and morbidly obese (BMI > 35 kg m−2) women were 1.53 (1.48, 1.58), 2.26 (2.04, 2.51) and 3.38 (2.49, 4.57) respectively. The pooled odds of having an emergency caesarean section were 1.64 (95% confidence intervals 1.55, 1.73) in overweight and 2.23 (2.07, 2.42) in obese women. Caesarean delivery risk is increased by 50% in overweight women and is more than double for obese women compared with women with normal BMI.
Hazardous drinking is associated with an elevated aspartate aminotransferase to platelet ratio index in an urban HIV‐infected clinical cohort
Authors: Chaudhry AA , Sulkowski MS , Chander G , Moore RD 
Published: December 2008

ObjectivesThe aim of the study was to determine the relationship between alcohol consumption and liver fibrosis as assessed by aspartate aminotransferase to platelet ratio index (APRI) in HIV‐infected adults and to explore the relative contributions of alcohol and hepatitis C virus (HCV) to APRI among HIV/HCV‐coinfected adults.MethodsWe performed a cross‐sectional analysis of data from an observational clinical cohort. Alcohol consumption was categorized according to National Institute on Alcohol Abuse and Alcoholism guidelines. We defined significant liver disease as APRI>1.5, and used multinomial logistic regression to identify correlates of increased APRI.ResultsAmong 1358 participants, 10.4% reported hazardous drinking. It was found that 11.6% had APRI>1.5, indicating liver fibrosis. Hazardous drinking was associated with increased APRI [adjusted relative risk ratio (RRR) 2.30; 95% confidence interval (CI) 1.26–4.17]. Other factors associated with increased APRI were male gender, viral hepatitis, and HIV transmission category of injecting drug use. Among coinfected individuals, 18.3% had APRI>1.5, and hazardous drinking was not associated with APRI. Among non‐HCV‐infected individuals, 5.3% had APRI>1.5 and hazardous drinking was associated with increased APRI (adjusted RRR 3.72; 95% CI 1.40–9.87).ConclusionsHazardous drinking is an important modifiable risk factor for liver fibrosis, particularly among non‐HCV‐infected patients. Clinicians and researchers must address alcohol use as the burden of liver disease increases among HIV‐positive individuals.
Effect of nucleoside reverse transcriptase inhibitors on CD4 T‐cell recovery in HIV‐1‐infected individuals receiving long‐term fully suppressive combination antiretroviral therapy
Authors: Byakwaga H , Zhou J , Petoumenos K , Law MG , Boyd MA , Emery S , Cooper DA , Mallon PW 
Published: December 2008

ObjectiveThe aim of the study was to determine the effect of nucleoside reverse transcriptase inhibitors (NRTIs) on CD4 recovery in HIV‐1‐infected individuals receiving long‐term suppressive combination antiretroviral therapy (cART).MethodsA retrospective cohort study was carried out. The mean time‐weighted CD4 change from baseline was determined at weeks 48, 96 and 144: its associations with exposure to NRTIs were assessed using linear regression.ResultsOne hundred and five patients were included. Their median baseline CD4 count was 225 (interquartile range 91–362) cells/μL. A trend of greater CD4 change from baseline was observed for individuals who at baseline had CD4 counts >200 cells/μL (138 vs. 113, 176 vs. 134 and 204 vs. 173 cells/μL), or were ≤40 years old (136 vs. 118, 182 vs. 150, 208 vs. 174) at weeks 48, 96 and 144, respectively; however, all P‐values were >0.05. Lower CD4 increases were observed in patients exposed to didanosine (ddI) or a combination of ddI and stavudine, although the difference was not statistically significant. For patients that commenced cART with CD4 count ≤200 cells/μL, a trend towards a CD4 count response <250 cells/μL at weeks 48, 96 and 144 was observed in patients receiving zidovudine.ConclusionExposure to different NRTIs in initial cART was not significantly associated with variable rises in CD4 cell count. However, these findings need to be confirmed in larger studies.
Diagnostic accuracy of cardiac metaiodobenzylguanidine scintigraphy in Parkinson disease
Authors: Sawada H. , Oeda T. , Yamamoto K. , Kitagawa N. , Mizuta E. , Hosokawa R. , Ohba M. , Nishio R. , Yamakawa K. , Takeuchi H. , Shimohama S. , Takahashi R. , Kawamura T. 
Published: December 2008

Background and purpose:  To estimate the diagnostic accuracy of cardiac 123I‐metaiodobenzylguanidine (MIBG) scintigram for detection of Parkinson disease.Methods:  A cross‐sectional study with index test of MIBG scintigram and reference standard of U.K. Parkinson’s Disease Brain Bank Criteria was performed in 403 patients. Ratio of cardiac‐to‐mediastinum MIBG accumulation was determined at 20 min (early H/M) and 4 h (late H/M). Area under the receiver‐operator characteristic (ROC) curve, sensitivity and specificity in detecting Parkinson disease were analyzed. Accuracy was analyzed in a subgroup of patients with disease duration of 3 years or less.Results:  Area under the ROC curve was 0.89 using either early or late H/M as a diagnostic marker (95% CI 0.85–0.92 for early H/M and 0.86–0.93 for late H/M). Sensitivity and specificity were 81.3% (76.1–85.8%) and 85.0% (77.7–90.6%) for early H/M and 84.3% (79.3–88.4%) and 89.5% (83.01–94.1%) for late H/M. In the subgroup with duration of 3 years or less, the ROC curve area, sensitivity, and specificity were 0.86 (0.79–0.92), 76.0% (64.8–85.1%), and 83.9% (71.7–92.4%) for early H/M and 0.85 (0.78–0.92), 73.3% (61.9–82.9%), and 87.5% (75.9–94.8%) for late H/M.Conclusion:  Although diagnostic accuracy of cardiac MIBG scintigram is high, it is limited because of insufficient sensitivity in patients with short duration.
Parkinson’s disease and nursing home placement: the economic impact of the need for care
Authors: Vossius C. , Nilsen O. B. , Larsen J. P. 
Published: December 2008

Background and Purpose:  To examine the relative risk (RR) for living in nursing homes for patients with Parkinson’s disease (PD) compared with the general population and to ascertain society’s costs related to nursing home placement for this patient group.Methods:  We evaluated the frequency of admission to nursing homes in a cross‐sectional study and during a 12‐year follow‐up study of 108 patients with PD and 864 controls who were matched for age and sex. The RR for living in a nursing home was calculated at baseline and during follow‐up. On the basis of 2007 prices, we estimated the costs per person year of survival for patients with PD and controls.Results:  The RR for living in a nursing home at baseline was 5.0 for patients with PD and 4.8 during follow‐up. Patients with PD caused 4.8 times higher costs for nursing home placement with euro 18 875 versus euro 3978 per individual and year. The annual costs for institutional care of patients with PD in Norway were euro 132 million.Conclusion:  Patients with PD have a substantially higher risk for living in nursing homes than the general population. This causes high costs to society. Therapeutic interventions to prevent or delay nursing home admissions are therefore important.
Disrupted sleep and circadian patterns in frontotemporal dementia
Authors: Anderson K. N. , Hatfield C. , Kipps C. , Hastings M. , Hodges J. R. 
Published: December 2008

Background:  A study of the pattern of Sleep/Wake disturbance in frontotemporal dementia (FTD).Methods:  Sleep diaries and prolonged actigraphy were used to record the activity, sleep and wake of 13 patients with a clinical diagnosis of FTD. These were compared with diaries and actigraphy from normal age/sex matched controls and also to a population with probable Alzheimer’s disease (AD).Results:  There was significant sleep/wake disturbance in FTD. This occurred throughout the course of the illness and the nature of the sleep disturbance was different to patients with AD. FTD subjects showed increased nocturnal activity and decreased morning activity compared with controls, suggesting possible phase delay. Sleep diary data confirmed decreased sleep efficiency and decreased total sleep in all FTD patients.Conclusions:  We describe significant sleep disturbance in non‐institutionalized patients with FTD and suggest that early sleep disturbance may help differentiate between FTD and AD.
Population‐based case–control study of morale in Parkinson’s disease
Authors: Benito‐León J. , Louis E. D. , Bermejo‐Pareja F. ,   on behalf of the Neurological Disorders in Central Spain (NEDICES) Study Group
Published: December 2008

Background:  Parkinson’s disease (PD) is associated with cognitive, psychiatric, and motor features. Each could contribute to a poor sense of well‐being and low morale. A systematic study of morale in community‐dwelling PD cases has not been performed.Methods:  A total of 52 PD cases and 260 matched controls from three Spanish communities were assessed using the Philadelphia Geriatric Center Morale Scale (PGCMS) (range = 0[low morale]–17). The PGCMS includes three dimensions of psychological well‐being: agitation, lonely dissatisfaction, and attitude toward own aging.Results:  The PGCMS score was lower in PD cases than controls (8.71 ± 3.64 vs. 11.03 ± 2.77, P < 0.001), as were the agitation subscore (3.36 ± 1.91 vs. 4.07 ± 1.59, P < 0.05), lonely dissatisfaction subscore (3.48 ± 1.36 vs. 4.11 ± 1.12, P < 0.01), and attitude toward own aging subscore (1.86 ± 1.37 vs. 2.85 ± 1.13, P < 0.001). In a linear regression analysis that adjusted for depressive symptoms and other covariates, PD cases had a lower PGCMS score than controls (P < 0.001).Conclusions:  Morale was significantly lower in community‐dwelling PD cases than matched controls. The detection and possible treatment of this problem may improve the psychological well‐being of patients with this disease.
THE PREVENIENCE AND PHENOMENALITY OF GRACE, OR, THE ANTERIORITY OF THE POSTERIOR
Authors: PURCELL MICHAEL 
Published: December 2008

This article argues the possibility of a phenomenology of Grace on the basis of response. Its key phenomenological interlocutor is Emmanuel Levinas.The theology of grace might be said to be the fundamental theological doctrine, embracing as it does all other theologies, yet the theology of grace has been a focus of theological debate and dispute throughout history.This article suggests that Levinas' ethical metaphysics, when applied to theology, gives theology a new phenomenological voice in which the theology of grace might be articulated.It begins by arguing the significance of the ordinary and the everyday and the sincerity of intentional life in the world, and then proceeds to develop the notion of the prevenience of grace (gratia praeveniens) in terms of Levinas notion of the posteriority of the anterior/anteriority of the posterior. Grace is known in its effects.
See no evil: Directing visual attention within unpleasant images modulates the electrocortical response
Authors: Dunning Jonathan P. , Hajcak Greg 
Published: December 2008

AbstractThe late positive potential (LPP) is larger for emotional than neutral stimuli, and reflects increased attention to motivationally salient stimuli. Recent studies have shown that the LPP can also be modulated by stimulus meaning and task relevance. The present studies sought to determine whether the magnitude of the LPP can be manipulated by directing attention to more or less arousing aspects within an emotional stimulus. To this end, trials included a passive viewing and directed attention portion. In both Studies 1 and 2, unpleasant compared to neutral images were associated with an increased LPP during passive viewing; additionally, directing attention to non‐arousing compared to highly arousing areas of unpleasant images resulted in a decreased LPP. Results are discussed in terms of the utility of using the LPP to understand emotion–cognition interactions, especially with regard to directed visual attention as an emotion regulation strategy.
Distinguishing range expansions from previously undocumented populations using background data from museum records
Authors: Frey Jennifer K. 
Published: December 2008

ABSTRACTAim Knowledge of the distribution of a species is fundamental to understanding the species’ biology, and changes in known distribution may reflect response to environmental change. However, in many cases, purported range expansions are not adequately justified and extra‐limital records may simply reflect previously undocumented populations. Thus, it is critical to distinguish between these hypotheses. This study aimed to provide a simple, conceptual framework for evaluating these hypotheses that depends on the use of museum background data to assess the adequacy of historical sampling.Location American Southwest and worldwide.Methods Background data are records of species other than the taxon of interest that are likely to be documented using the same sampling methods. If evaluation of the background group determines that the taxon of interest would have been documented if present, then the extra‐limital record can be considered a range expansion. Conversely, if evaluation of the background group indicates that historical sampling was inadequate to have documented the taxon of interest, then the most parsimonious explanation for the extra‐limital record is an undocumented population, which should be presented as a range extension. As an example, I applied the methods to a purported range expansion of the yellow‐nosed cotton rat (Sigmodon ochrognathus) in the Rincon Mountains in south‐eastern Arizona.Results Evaluation of the background group revealed that sampling was inadequate to have documentedS. ochrognathusin the Rincon Mountains if present. Thus, the record ofS. ochrognathusin the Rincon Mountains was interpreted as a previously undocumented population rather than a range expansion.Main conclusion Range expansions can reflect factors that are of important conservation concern, such as climate change or habitat modification. Thus, it is essential that the cause of extra‐limital records be accurately interpreted. The method provides a simple means for testing between hypotheses of range extension and range expansion.