bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urinary concentration of transforming growth factor‐β‐inducible gene‐h3(βig‐h3) in patients with Type 2 diabetes mellitus
Authors: Cha D. R. , Kim I. S. , Kang Y. S. , Han S. Y. , Han K. H. , Shin C. , Ji Y. H. , Kim N. H. 
Published: December 2004

AbstractAims  The expression of TGFβ‐inducible gene h3(βig‐h3) has been used to assess the biological activity of TGFβ in the kidney. In this study, we investigated whether the urinary concentration of βig‐h3 is associated with diabetic nephropathy in patients with Type 2 diabetes mellitus. We also evaluated the relationship between the urinary concentration of βig‐3 and proteinuria and microalbuminuria (AER) in a normal healthy population and in Type 2 diabetes patients.Methods  Four hundred and seventy‐nine Type 2 diabetic patients without non‐diabetic kidney diseases and 528 healthy control subjects were enrolled. The study subjects were divided into five groups: a non‐diabetic healthy control group with normal ACR (n = 443), a non‐diabetic healthy control group with microalbuminuria (n = 85), a normoalbuminuric diabetic group (n = 198), a microalbuminuric diabetic group (n = 155) and an overt proteinuria group (n = 126). Urinary levels of βig‐h3 were measured by enzyme‐linked immunosorbent assay.Results  (i) Urinary excretion of βig‐h3 was significantly higher in the diabetic groups than in the controls, even in the normoalbuminuric stage (25.02 ± 8.84 vs. 18.67 ± 6.56, P = 0.03). In diabetic patients, urinary βig‐h3 levels increased significantly as diabetic nephropathy advanced (25.02 ± 8.84 vs. 34.06 ± 24.55 vs. 169.63 ± 57.33, P < 0.001). (ii) Proteinuria was found to be significantly correlated with urinary βig‐h3 (healthy control; r = 0.137, P = 0.019, diabetic patients; r = 0.604, P < 0.001). ACR was also found to be significantly related with urinary βig‐h3 in diabetic patients (r = 0.383, P = 0.006). (iii) In diabetic patients, urinary βig‐h3 was significantly related with systolic and diastolic blood pressure (systolic blood pressure: r = 0.436, P = 0.024; diastolic blood pressure, r = 0.365, P = 0.042), total cholesterol and HbA1c (cholesterol: r = 0.169, P = 0.03, HbA1c; r = 0.387, P = 0.044). Logistic regression analyses showed that urinary βig‐h3 was associated with a significant increase in the risk of microalbuminuria and proteinuria in diabetic patients.Conclusions  Longitudinal monitoring of urinary βig‐h3 may improve the likelihood of detecting diabetic nephropathy at an earlier stage and βig‐h3 could be a sensitive marker of diabetic kidney disease progression.
Barriers to following dietary recommendations in Type 2 diabetes
Authors: Vijan S. , Stuart N. S. , Fitzgerald J. T. , Ronis D. L. , Hayward R. A. , Slater S. , Hofer T. P. 
Published: December 2004

AbstractAims  To evaluate barriers to following dietary recommendations in patients with Type 2 diabetes.Methods  We conducted focus groups and surveys in urban and suburban VA and academic medical centres. For the written survey, a self‐administered questionnaire was mailed to a random sample of 446 patients with diabetes. For the focus groups, six groups of patients with diabetes (three urban, three suburban) were conducted, with 6–12 participants in each group. The focus groups explored barriers across various types of diabetes self‐management; we extracted all comments relevant to barriers that limited patients’ ability to follow a recommended diet.Results  The written survey measured the burden of diabetes therapies (on a seven‐point rating scale). Moderate diet was seen as a greater burden than oral agents (median 1 vs. 0, P = 0.001), but less of a burden than insulin (median 1 vs. 4, P < 0.001). A strict diet aimed at weight loss was rated as being similarly burdensome to insulin (median 4 vs. 4, P = NS). Despite this, self‐reported adherence was much higher for both pills and insulin than it was for a moderate diet. In the focus groups, the most commonly identified barrier was the cost (14/14 reviews), followed by small portion sizes (13/14 reviews), support and family issues (13/14 reviews), and quality of life and lifestyle issues (12/14 reviews). Patients in the urban site, who were predominantly African‐American, noted greater difficulties communicating with their provider about diet and social circumstances, and also that the rigid schedule of a diabetes diet was problematic.Conclusions  Barriers to adherence to dietary therapies are numerous, but some, such as cost, and in the urban setting, communication with providers, are potentially remediable. Interventions aimed at improving patients’ ability to modify their diet need to specifically address these areas. Furthermore, treatment guidelines need to consider patients’ preferences and barriers when setting goals for treatment.
The association of smoking and subclinical atherosclerosis in Type 2 diabetes: modification by duration of diabetes
Authors: Karim R. , Buchanan T. A. , Hodis H. N. , Li Y. , Mack W. J. 
Published: December 2004

AbstractBackground  Diabetes is a relatively common disease in the United States, and cardiovascular disease is the major cause of morbidity and mortality among persons with diabetes. While smoking is one of the most well‐established risk factors for heart disease and atherosclerosis, the effect of smoking on atherosclerosis among diabetic patients has not been thoroughly investigated. The primary objective of this paper was to evaluate the impact of smoking on atherosclerosis among Type 2 diabetic patients and to evaluate whether smoking associations with atherosclerosis are modified by diabetes‐related variables.Methods  We used cross‐sectional baseline data from a randomized controlled trial to evaluate the associations between smoking and common carotid artery intima‐media thickness (IMT) in 299 subjects with Type 2 diabetes. There were 34 (11%) current cigarette smokers, 73 (24%) former cigarette smokers, and 192 (64%) subjects who had never smoked regularly.Results  There was an increasing trend in mean carotid IMT with both longer duration and increased frequency of smoking (adjusted P for trend 0.04 and 0.02, respectively). The mean ± SE carotid IMT was non‐significantly thicker (0.872 ± 0.01 mm) in diabetic patients who had ever smoked than never smokers (0.842 ± 0.01 mm) after controlling for age, gender and other potential confounders (P = 0.08). The negative effects of ever smoking (P = 0.01 for interaction), number of cigarettes smoked daily (P = 0.003 for interaction) and duration of smoking (P = 0.03 for interaction) on carotid IMT were accentuated with longer duration of diabetes.Conclusion  Smoking is associated with subclinical atherosclerosis in diabetic persons and interacts with duration of diabetes to accentuate atherosclerosis. The association between carotid IMT and duration of diabetes increases with both the frequency and duration of smoking.
Factors predicting the blood glucose lowering effect of a 30‐day very low calorie diet in obese Type 2 diabetic patients
Authors: Jazet I. M. , Pijl H. , Frölich M. , Schoemaker R. C. , Meinders A. E. 
Published: December 2004

AbstractObjective  To identify factors which predict the blood glucose lowering effect of monotherapy with a 30‐day very low calorie diet (VLCD) in obese Type 2 diabetic patients. A responder was a priori defined as a patient with a fasting plasma glucose (FPG) level < 10 mmol/l on day 30.Research design and methods  In 17 obese patients (BMI 37.6 ± 5.6 (mean ± SD) kg/m2) with Type 2 diabetes, all blood glucose lowering medication (including insulin) was discontinued on day −1 followed by a 30‐day VLCD. On day 2 and 30 of the VLCD an intravenous glucose tolerance test (IVGTT) was performed.Results  Of the 14 patients who completed the 30‐day VLCD, eight qualified as responder. Responders and non‐responders could be distinguished by day 2. Responders had a shorter duration of Type 2 diabetes and higher fasting serum insulin, C‐peptide and HOMA‐β‐values. In addition, responders displayed a more prominent second‐phase insulin response following i.v. glucose loading and higher k‐values. In a stepwise discriminant analysis, the change in FPG from day 0 to day 2 (responders +0.64 ± 2.3, non‐responders +4.15 ± 3.3 mmol/l, P = 0.035) in combination with the area under the curve of insulin (AUC) above baseline during an IVGTT on day 2 (responders 571 ± 236, non‐responders 88 ± 65 mU*50 min, P < 0.001), distinguished responders completely from non‐responders.Conclusion  Preservation of the capacity of β‐cells to secrete insulin predicts a favourable metabolic response to a VLCD in obese Type 2 diabetic patients.
Rupture of the uterine scar during term labour: contractility or biochemistry?
Authors: Buhimschi Catalin S. , Buhimschi Irina A. , Patel Shilpa , Malinow Andrew M. , Weiner Carl P. 
Published: December 2004

Objective  Vaginal birth after a prior low transverse caesarean section (VBAC) is advocated as a safe and effective method to reduce the total caesarean section rate. However, the risk of uterine rupture has dampened the enthusiasm of practising clinicians for VBAC. Uterine rupture occurs more frequently in women receiving prostaglandins in preparation for the induction of labour. We hypothesised that similar to the cervix, prostaglandins induces biochemical changes in the uterine scar favouring dissolution, predisposing the uterus to rupture at the scar of the lower segment as opposed to elsewhere.Design  We tested aspects of this hypothesis by investigating the location of uterine rupture associated with prostaglandins and compared it with the sites of rupture in the absence of prostaglandins.Settings  Two North American University Hospitals.Population  Twenty‐six women with a prior caesarean section, experiencing uterine rupture in active labour.Methods  Retrospective review of all pregnancies complicated by uterine rupture at two North American teaching hospitals from 1991 to 2000.Main outcome measure  Site of the uterine rupture.Results  Thirty‐four women experienced rupture after a previous caesarean section with low transverse uterine incision. Ten of the women who ruptured (29%) received prostaglandins for cervical ripening (dinoprostone: n= 8 or misoprostol: n= 2) followed by either spontaneous contractions (n= 3) or oxytocin augmentation during labour (n= 7). In 16 women (47%), oxytocin alone was sufficient for the induction/augmentation of labour. Eight (23%) women ruptured at term before reaching the active phase of labour in the absence of pro‐contractile agents or attempted VBAC. There were no differences among the groups in terms of age, body mass index, parity, gestational age, fetal weight or umbilical cord pH measurements. Women treated with prostaglandins experienced rupture at the site of their old scar more frequently than women in the oxytocin‐alone group whose rupture tended to occur remote from their old scar (prostaglandins 90%vs oxytocin 44%; OR: 11.6, 95% CI: 1.2–114.3).Conclusion  Women in active labour treated with prostaglandins for cervical ripening appear more likely to rupture at the site of their old scar than women augmented without prostaglandins. We propose that prostaglandins induce local, biochemical modifications that weaken the scar, predisposing it to rupture.
Incidence of severe pre‐eclampsia, postpartum haemorrhage and sepsis as a surrogate marker for severe maternal morbidity in a European population‐based study: the MOMS‐B survey
Authors: Zhang Wei‐Hong , Alexander Sophie , Bouvier‐Colle Marie‐Hélène , Macfarlane Alison ,   the MOMS‐B Group
Published: December 2004

Objective  To describe the incidence of three conditions of acute severe maternal morbidity in selected regions in nine European countries.Design  A population‐based questionnaire survey.Setting  Eleven regions in nine countries of Europe.Population  All the pregnant women in each region who had delivered during the period covered by the study.Methods  Standard definitions of three severe obstetric conditions, pre‐eclampsia, postpartum haemorrhage and sepsis were established by a steering committee. A common questionnaire was used in each participating country. The incidence of the three obstetric conditions and characteristics of the study women were compared.Main outcome measures  Incidence of three severe obstetric conditions: pre‐eclampsia, postpartum haemorrhage and sepsis.Results  The study identified 1734 women with at least one of the three conditions, with 847 experiencing severe haemorrhage, 793 experiencing severe pre‐eclampsia and 142 experiencing severe sepsis. There were wide variations in incidence of three conditions combined, ranging from 14.7 per thousand deliveries in Brussels, Belgium to 6.0 per thousand deliveries in Upper Austria.Conclusions  This study sets a simple and straightforward approach to the definition of three severe obstetric conditions and allows population‐based comparisons between developed countries in Europe, even though difficulties may have been present with applying the definition across countries. The reported incidence of these severe obstetric conditions in general and severe haemorrhage varied significantly between countries. Overall, severe haemorrhage in particular was the most common of the three conditions, followed closely by severe pre‐eclampsia.
A comparison of fetal organ measurements by echo‐planar magnetic resonance imaging and ultrasound
Authors: Duncan Keith R. , Issa Bashar , Moore Rachel , Baker Philip N. , Johnson Ian R. , Gowland Penny A. 
Published: December 2004

Objectives  To compare fetal organ size measured using echo‐planar magnetic resonance imaging and 2D ultrasound. To determine the relative accuracy with which each technique can predict fetal growth restriction.Design  A cross sectional, observational study comparing two different measurement techniques against a gold standard, in a normal clinical population and an abnormal population.Setting and Population  Seventy‐four pregnant women (33 who were ultimately found to be normal and 37 with fetal growth restricted fetuses) were recruited from the City Hospital Nottingham UK to be scanned once (at various gestations).Methods  Each fetus had a standard ultrasound biometry assessment followed by magnetic resonance imaging measurement of organ volumes.Main outcome measures  For each measurement for both techniques, the normal population was plotted with 90% confidence intervals. Fetal growth restricted subjects were compared with the normal population using this plot; 2 × 2 tables were created for each measurement. This was used to calculate the relative sensitivities and positive predictive value of the different measurements. A Bland–Altman plot was used to compare the ultrasound and magnetic resonance imaging measurements of fetal weight.Results  Brain sparing was seen in ultrasonic head circumference measurements, but an overall reduction in fetal growth restriction brain volume was apparent using magnetic resonance imaging at late gestations. Across the whole range of gestational ages, ultrasound assessment of fetal weight was the best predictor of fetal growth restriction.Conclusion  Ultrasound fetal weight assessment appears to identify more fetuses with fetal growth restriction than abdominal circumference. The brain sparing apparent in ultrasonic head circumference measurements of fetuses with fetal growth restriction masks a reduction in brain volume observed with magnetic resonance imaging.
Evaluation of endocervical, first‐void urine and self‐administered vulval swabs for the detection of Chlamydia trachomatis in a miscarriage population
Authors: Logan S. , Browne J. , McKenzie H. , Templeton A. , Bhattacharya S. 
Published: December 2004

Objective  To compare, in parallel, different approaches of opportunistically screening women with bleeding in early pregnancy for Chlamydia trachomatis.Design  Cross‐sectional study.Setting  Early pregnancy assessment unit, University hospital, Scotland, UK.Population  Over 200 consecutive women admitted to an early pregnancy assessment unit were recruited. All had a positive pregnancy test, a history of vaginal bleeding and were less than 24 weeks of gestation. Women with recent antibiotic use, heavy vaginal bleeding and cervical shock excluded.Methods  Each women provided two or more of the following specimens: a self‐administered vulval swab, first‐void urine and/or endocervical swab. Following screening, each completed a semi‐structured questionnaire assessing the acceptability of each method undertaken.Main outcome measure  Subjective rating of the screening methods; prevalence; method performance, including proportion requiring repeat testing.Results  The majority accepted screening, with moderate prevalence rates (95% CI) 3.9% (2.0–7.4%) identified. All positive women were less than 30 years of age. Parallel screening exposed the potential of reduced test performance with urine. Non‐invasive sampling was more acceptable, but more likely to require repeat testing.Conclusion  Both acceptability and the effect of bleeding on test performance need further assessment before a particular specimen can be recommended for screening this population of women for C. trachomatis.
Functional and anatomical outcome of anterior and posterior vaginal prolapse repair with prolene mesh
Authors: Milani Rodolfo , Salvatore Stefano , Soligo Marco , Pifarotti Paola , Meschia Michele , Cortese Marina 
Published: December 2004

Objective  To evaluate the effects of prolene mesh on urinary, bowel and sexual function in prolapse surgery.Design  Prospective observational study on consecutive women.Setting  Two referral uorgynaecological units in Italy.Population  Women requiring prolapse repair for anterior or posterior vaginal prolapse.Methods  All women were assessed for urinary, bowel, prolapse symptoms and dyspareunia pre‐ and post‐operatively. Urodynamics was performed in selected cases. Surgery consisted of an anterior or posterior repair plus a prolene mesh. Follow up was after 1, 6 and 12 months. The ANOVA test was used for statistical analysis.Main outcome measures  Vaginal anatomical restoration, urinary, bowel and sexual function.Results  We recruited 63 women (mean age 63 years) with a mean follow up of 17 months. Anatomically, the success rate was 94%. Thirty‐two women had an anterior repair. Among this group, the sexual activity rate did not alter but dyspareunia increased by 20%. Urge and stress incontinence did not change post‐operatively but urgency improved in 10% and 13% had vaginal erosion of the mesh. Thirty‐one women had a posterior repair. Among this group, sexual activity decreased by 12% and dyspareunia increased in 63%. Constipation improved in 15% and anal incontinence in 4%, and 6.5% of women had vaginal erosion of the mesh and one required mesh removal for pelvic abscess.Conclusions  Although this study shows good anatomical results with the use of prolene mesh for prolapse repair, there was a high rate of morbidity. We believe that the use of prolene mesh should be abandoned.
Concentration of cord serum placenta growth factor in normal and diabetic pregnancies
Authors: Loukovaara Mikko , Leinonen Pekka , Teramo Kari , Andersson Sture 
Published: December 2004

Objective  To investigate whether maternal diabetes or diabetes‐related complications, such as macrosomia and chronic fetal hypoxia, are associated with altered placenta growth factor (PlGF) levels in cord serum.Design  Case–control study.Setting  Helsinki University Central Hospital, Helsinki, Finland.Population  Sixty‐two normal pregnancies, 67 pregnancies complicated by type 1 diabetes and 28 pregnancies complicated by insulin‐treated gestational diabetes.Methods  Cord serum PlGF concentration was measured by an enzyme‐linked immunosorbent assay. Amniotic fluid erythropoietin concentration was measured by a chemiluminescent immunologic method. Umbilical artery gas variables were analysed with standard blood gas and pH electrodes.Main outcome measure  PlGF concentration in cord serum at birth.Results  Cord serum PlGF concentration was similar in normal pregnancies [13.4 (1.0) ng/L], in pregnancies complicated by type 1 diabetes [15.1 (1.8) ng/L, P= 0.583 vs controls] and in pregnancies complicated by insulin‐treated gestational diabetes [13.6 (0.9) ng/L, P= 0.991 vs controls]. Cord serum PlGF did not correlate with relative birthweight. In diabetic pregnancies, cord serum PlGF correlated negatively with amniotic fluid erythropoietin (r=−0.449, P < 0.0001) and positively with umbilical artery Po2 (r= 0.333, P= 0.001). There was a trend toward lower cord serum PlGF levels in diabetic pregnancies with pre‐eclampsia compared with those without any hypertensive disorders.Conclusions  Maternal diabetes per se is not associated with altered PlGF levels in cord serum. The correlation between PlGF and indices of fetal hypoxia in diabetic pregnancies may be related to the role of PlGF in potentiating the angiogenic response to vascular endothelial growth factor in ischaemia.
Corundum–quartz‐bearing assemblage in the Ihouhaouene area (In Ouzzal, Algeria)
Authors: GUIRAUD M. , KIENAST J.‐R. , OUZEGANE K. 
Published: December 2004

ABSTRACTGranulite facies quartzites from the Ihouhaouene region, in the northern part of In Ouzzal, contain the assemblage corundum+quartz+magnetite together with hercynitic spinel+quartz+magnetite, sillimanite+quartz+magnetite and almandine‐rich garnet+quartz+magnetite. Two types of corundum have been recognized: the first is primary and is found with quartz and magnetite only; the second type is found together with magnetite and chlorite rimming spinel as a fine‐grained corona. The textures show that spinel‐rich magnetite probably exsolved primary corundum, sillimanite, spinel and garnet during the cooling history. The secondary corundum formed later from the spinel already exsolved from magnetite. The secondary corundum is certainly metastable with respect to quartz. This may also apply for the primary corundum. However, given the high‐temperature setting of this rock, it cannot be excluded that the stable contacts observed between primary corundum and quartz indicate equilibrium between the two phases. Taking into account the uncertainties in the thermodynamic data, the stability of this assemblage would imply that this part of In Ouzzal has recorded very high P–T conditions, above 1100°C at 12 kbar.