bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intra‐operative diagnosis of hypopituitarism in a patient undergoing radical nephrectomy
Authors: Pillai P. , Spears F. D. 
Published: August 2005

SummaryA 43‐year‐old woman presented for elective radical nephrectomy. After induction of anaesthesia, she developed hypotension that failed to respond to standard treatment measures. Her core temperature decreased to 34 °C in spite of active warming. She required very low concentrations of anaesthetic agents to maintain an adequate depth of anaesthesia for abdominal surgery. After excluding the common causes of hypotension, the possibility of subclinical hypopituitarism was considered and subsequently confirmed.
Dreaming during anaesthesia in children: incidence, nature and associations
Authors: Huang G. H. , Davidson A. J. , Stargatt R. 
Published: August 2005

SummaryIn previous studies, the incidence of dreaming during anaesthesia in children was reported to be between 9.7% and 19%. These limited studies were performed over 15 years ago using outmoded anaesthetic techniques. No recent studies have examined the nature of dreaming or its impact on children. In this prospective cohort study of 864 children, we determined the incidence, nature, predictors and behavioural consequences of children who reported dreaming during anaesthesia. Children aged 5–12 years who had undergone general anaesthesia were interviewed for dreaming on three occasions. Dreaming was reported by 10.4% of children. The content of the dreams was mostly pleasant and unrelated to their hospital experiences. Dreaming was more common in younger children and in children who had also experienced awareness during anaesthesia. No association was found between dreaming and the anaesthetic drugs used. Dreaming was not associated with an increased risk of behavioural disturbances postoperatively. Anaesthetists should be reassured that dreaming is a common occurrence that does not appear to distress children.
The diagnosis of acute renal failure in intensive care: mongrel or pedigree?
Authors: Tillyard A. , Keays R. , Soni N. 
Published: August 2005

SummaryAcute renal failure is common in the intensive care unit; it is well recognised that patients who develop acute renal failure have a high mortality rate. While there have been improvements in the management of acute renal failure, the mortality remains high. Acute renal failure is easily diagnosed biochemically and clinically but it is not a single disease entity. It is a syndrome that affects a very heterogeneous population. Studies of acute renal failure and of the impact of renal replacement therapy in intensive care are usually inconclusive, which may be the natural consequence of studying a syndrome. This article focuses on the more uncertain features of acute renal failure, the problems of investigating acute renal failure as a disease and the difficulties of applying the results of a study of a heterogeneous population to the management of individuals.
Application of MVBC equation to predict mixed venous blood concentrations of sevoflurane in cardiac anaesthesia
Authors: Ho W.‐M. , Hung W. T. , Wu C. C. , Shen C. H. , Yang N. C. , Hwang K. L. , Wong K. C. 
Published: August 2005

SummaryWe have proposed an equation for estimating the real‐time mixed venous blood concentration (MVBC) of isoflurane in cardiac anaesthesia. However, information related to the application of our method to sevoflurane is lacking. We studied 12 patients undergoing cardiac surgery and anaesthetised with sevoflurane. At different time points, pulmonary arterial blood samples were collected for gas chromatography‐mass spectrometry (GC‐MS) to determine the real mixed venous concentrations of sevoflurane. The inspired and expired concentrations of sevoflurane, measured by a gas monitor, were used for the MVBC calculations. Using Bland‐Altman analyses, we found that the calculated MVBCs accurately represent the actual concentrations of sevoflurane in pulmonary arterial blood, as shown by a near‐zero percentage bias with a 0.14% precision between the two concentrations. The results demonstrated that our equation could be a useful method for estimating the pulmonary blood concentration of sevoflurane.
A prospective, randomised, controlled study examining binaural beat audio and pre‐operative anxiety in patients undergoing general anaesthesia for day case surgery*
Authors: Padmanabhan R. , Hildreth A. J. , Laws D. 
Published: August 2005

SummaryPre‐operative anxiety is common and often significant. Ambulatory surgery challenges our pre‐operative goal of an anxiety‐free patient by requiring people to be ‘street ready’ within a brief period of time after surgery. Recently, it has been demonstrated that music can be used successfully to relieve patient anxiety before operations, and that audio embedded with tones that create binaural beats within the brain of the listener decreases subjective levels of anxiety in patients with chronic anxiety states. We measured anxiety with the State‐Trait Anxiety Inventory questionnaire and compared binaural beat audio (Binaural Group) with an identical soundtrack but without these added tones (Audio Group) and with a third group who received no specific intervention (No Intervention Group). Mean [95% confidence intervals] decreases in anxiety scores were 26.3%[19–33%] in the Binaural Group (p = 0.001 vs. Audio Group, p < 0.0001 vs. No Intervention Group), 11.1%[6–16%] in the Audio Group (p = 0.15 vs. No Intervention Group) and 3.8%[0–7%] in the No Intervention Group. Binaural beat audio has the potential to decrease acute pre‐operative anxiety significantly.
Correlation of EEG spectral entropy with regional cerebral blood flow during sevoflurane and propofol anaesthesia*
Authors: Maksimow A. , Kaisti K. , Aalto S. , Mäenpää M. , Jääskeläinen S. , Hinkka S. , Martens S. , Särkelä M. , Viertiö‐Oja H. , Scheinin H. 
Published: August 2005

SummaryENTROPY™ index monitoring, based on spectral entropy of the electroencephalogram, is a promising new method to measure the depth of anaesthesia. We examined the association between spectral entropy and regional cerebral blood flow in healthy subjects anaesthetised with 2%, 3% and 4% end‐expiratory concentrations of sevoflurane and 7.6, 12.5 and 19.0 μg.ml−1 plasma drug concentrations of propofol. Spectral entropy from the frequency band 0.8–32 Hz was calculated and cerebral blood flow assessed using positron emission tomography and [15O]‐labelled water at baseline and at each anaesthesia level. Both drugs induced significant reductions in spectral entropy and cortical and global cerebral blood flow. Midfrontal‐central spectral entropy was associated with individual frontal and whole brain blood flow values across all conditions, suggesting that this novel measure of anaesthetic depth can depict global changes in neuronal activity induced by the drugs. The cortical areas of the most significant associations were remarkably similar for both drugs.
Intraocular pressure during lumbar disc surgery in the knee‐elbow position
Authors: Tiefenthaler W. , Gabl M. , Teuchner B. , Benzer A. 
Published: August 2005

SummaryIncreased intraocular pressure is often implicated in the aetiology of postoperative visual impairment. Such an increase in intraocular pressure has been demonstrated in the prone position. We investigated intraocular pressure in seven patients undergoing lumbar disc surgery in the knee‐elbow position with the head resting on a cushion and turned to the side. Measurements were performed in the supine position before induction of anaesthesia and in the knee‐elbow position after surgery with the patient still anaesthetised. After a mean (SD) duration of prone positioning of 121 (18) min, mean (SD) intraocular pressure in the nondependent eye was unchanged when compared to the awake state (17.7 (2.4) mmHg vs 18.9 (5.5) mmHg), whereas the intraocular pressure in the dependent eye had significantly decreased (17.0 (3.6) mmHg vs 8.1 (1.8) mmHg; p < 0.01). These results may be important for choosing the optimal position for spinal surgery when an increase in intraocular pressure should be avoided.
Androgens, insulin resistance and vascular disease in men
Authors: Kapoor D. , Malkin C. J. , Channer K. S. , Jones T. H. 
Published: August 2005

SummaryType 2 diabetes mellitus is increasing globally and is an established risk factor for the development of atherosclerotic vascular disease. Insulin resistance is the hallmark feature of type 2 diabetes and is also an important component of the metabolic syndrome. There is evidence to suggest that testosterone is an important regulator of insulin sensitivity in men. Observational studies have shown that testosterone levels are low in men with diabetes, visceral obesity (which is strongly associated with insulin resistance), coronary artery disease and metabolic syndrome. Short‐term interventional studies have also demonstrated that testosterone replacement therapy produces an improvement in insulin sensitivity in men. Thus hypotestosteronaemia may have a role in the pathogenesis of insulin‐resistant states and androgen replacement therapy could be a potential treatment that could be offered for improvements in glycaemic control and reduction in cardiovascular risk, particularly in diabetic men.
The T1799A BRAF mutation is not a germline mutation in familial nonmedullary thyroid cancer
Authors: Xing Mingzhao 
Published: August 2005

SummaryObjective  Familial nonmedullary thyroid cancer (FNMTC) is relatively common but its predisposing genetic alteration is unclear. As the somatic T1799A BRAF mutation is highly prevalent in papillary thyroid cancer, the aim was to test whether this mutation was a susceptibility mutation for FNMTC.Subjects and methods  The T1799A BRAF mutation as a possible germline mutation was examined in 40 subjects from 23 families with a history of FNMTC. Direct DNA sequencing was performed on white blood cell DNA samples to analyse the mutation status.Results  No T1799A BRAF mutation was found in this group of subjects as germline mutation.Conclusion  The T1799A BRAF mutation is not a germline mutation or susceptibility genetic event for FNMTC.
Development of a sensitive enzyme immunoassay for anti‐Müllerian hormone and the evaluation of potential clinical applications in males and females
Authors: Al‐Qahtani A. , Muttukrishna S. , Appasamy M. , Johns J. , Cranfield M. , Visser J. A. , Themmen A. P. N. , Groome N. P. 
Published: August 2005

SummaryBackground and objective  Recent studies have found anti‐Müllerian hormone (AMH) to be a potentially important marker for the assessment of ovarian reserve and prediction of the success of in vitro fertilization (IVF) treatment. The objectives of this study were to develop a sensitive and specific assay for AMH and to evaluate the potential application of the assay. This assay will be then available to our collaborators in the UK and overseas.Design  Samples obtained as part of another prospective cross‐sectional study from infertility patients and another prospective longitudinal study from pregnant women were used in this study to measure AMH using a new double‐antibody enzyme‐linked immunosorbent assay (ELISA).Patients and measurements  AMH levels were evaluated in (i) serum and seminal fluid from males (normal and male factor infertility males), (ii) serum and follicular fluid from females (normal and female with unexplained infertility) and (iii) serum, amniotic fluid (AF) and coelomic fluid (CF) from pregnant women. AMH levels in the samples were measured by a newly developed ELISA.Result  The assay had a detection limit of < 0·078 ng/ml. High recoveries of spiked recombinant protein were observed from male and female sera and also from follicular, seminal, coelomic and amniotic fluids. The intra‐ and interassay coefficients of variation (CVs) were 3·6% and 4·0%, respectively. Serially diluted human samples gave dose–response curves parallel to the standard curve. Immunoreactivity was stable to sample storage at room temperature for several days and to multiple cycles of freezing and thawing. In seminal fluid, the AMH concentrations in a group of men with male factor infertility were insignificantly different from those in fertile men. By contrast, serum AMH concentrations were lower in the male factor infertility group than the normal group of patients. Women with unexplained infertility had similar concentrations of AMH in serum and follicular fluid compared to controls. Pregnant women had higher concentrations of AMH in the circulation in early pregnancy compared with nonpregnant women, suggesting a foeto‐placental contribution and a possible biological role for this molecule in early pregnancy.Conclusion  We have developed a sensitive and specific assay for AMH. Serum AMH in men with male factor infertility is lower than in normal men. Levels of AMH in pregnancy are higher than normal menstrual cycle levels suggesting a foeto‐placental contribution.
Is dermolipectomy effective in improving insulin action and lowering inflammatory markers in obese women?
Authors: Rizzo M. R. , Paolisso G. , Grella R. , Barbieri M. , Grella E. , Ragno E. , Grella R. , Nicoletti G. , D’Andrea F. 
Published: August 2005

SummaryObjective  Obesity is a major risk factor for coronary heart disease, and surgical treatment of obese patients as part of a multidisciplinary approach seems to provide faster results than diet therapy. The aim of this study was to evaluate the effect of dermolipectomy on insulin action and inflammatory markers in 20 obese women.Patients  At baseline and 40 days after dermolipectomy, 20 obese women underwent indirect calorimetry and hyperinsulinaemic glucose clamp. Twenty obese nonsmoking females (age range 25–40 years) volunteered for the study. All subjects had a stable body weight for 2 months before the study. No patient was affected by cardiovascular and/or pulmonary disease, type 2 diabetes, thyroid dysfunction, acute or chronic hepatitis, renal insufficiency or cancer. No patients was receiving any drug therapy and all measurements were made during the follicular phase of the menstrual cycle.Results  At baseline, fat mass (FM) correlated with plasma triglycerides (r = 0·58, P < 0·009), free fatty acids (FFA) (r = 0·73, P < 0·001), insulin (r = 0·70, P < 0·002), leptin (r = 0·55, P < 0·01), adiponectin (r = –0·32, P < 0·02) and resistin (r = 0·31, P < 0·01), insulin sensitivity (IS) (r = –0·59, P < 0·005) and respiratory quotient (Rq) (r = 0·62, P < 0·002). With regard to inflammatory markers, FM was significantly correlated with plasma interleukin (IL)‐6 (r = 0·71, P < 0·001), IL‐10 (r = –0·67, P < 0·002), tumour necrosis factor‐α (TNF‐α) (r = 0·78, P < 0·001) and soluble IL‐6 receptor (sIL‐6r) (r = –0·65, P < 0·003). Dermolipectomy resulted in a significant decline in total FM of 2·3 ± 0·2 kg. A significant decline in BMI was also observed (30·0 ± 0·08 vs. 31·1 ± 0·7 kg/m2). After 40 days a significant decline in plasma resistin (P < 0·001) and inflammatory markers and an increase in plasma adiponectin (P < 0·03) were observed. Those metabolic changes were accompanied by a significant improvement in insulin‐mediated glucose uptake (P < 0·001), substrate oxidation and degree of inflammation. Changes in FM following dermolipectomy correlated with the changes in IS (P < 0·01), substrate oxidation and FFA (P < 0·001).Conclusions  In obese patients, dermolipectomy is associated with weight lost, improved glucose handling and lower inflammatory markers.
Effect of different therapeutic modalities on spontaneous GH secretion in acromegalic patients
Authors: Resmini Eugenia , Barreca Antonina , Ferone Diego , Giusti Massimo , Sidoti Marilena , Minuto Francesco 
Published: August 2005

SummaryObjectives  Three major therapeutic modalities (transsphenoidal surgery, radiotherapy and medical therapy) are currently available for acromegaly. Although surgery is regarded as the primary option, 50–60% of macroadenomas require further treatment in the form of radiotherapy and/or medical therapy. Recent studies have suggested that radiotherapy might damage the normal hypothalamic–pituitary axis and also rarely leads to IGF‐I normalization. The aims of this study were: (1) to examine the effect of different therapeutic modalities (transsphenoidal surgery, TSS; radiotherapy, RT; medical treatment with somatostatin analogues, SSA) on the daily spontaneous GH secretory pattern (day curve); and (2) to determine the relationship between the characteristics of the GH secretory pattern and the circulating concentration of IGF‐I, acid‐labile subunit (ALS) and IGFBP‐3.Design and measurements  Spontaneous GH secretion was evaluated at hourly intervals from 0800 to 1800 h. IGF‐I, IGFBP‐3 and ALS were measured in basal conditions. The mean and the minimum values obtained from the day curve profile and the coefficient of variation (CV) of single values, which are expressions of the magnitude of the spontaneous secretory pulses, were used for statistical analysis.Patients  In a group of 45 acromegalic patients (28 women, mean age 51 years, range 26–83 years, and 17 men, mean age 57 years, range 37–78 years) treated with different protocols, including TSS, RT and SSA therapy, we evaluated GH secretion to determine the effect of single treatment options on the spontaneous secretory profile. Subjects were grouped on the basis of different therapeutic modalities: TSS + RT + SSA (group 1), TSS + SSA (group 2), SSA (group 3), TSS (group 4), TSS + RT (group 5). In patients treated with somatostatin analogues (SSA), tests were performed about midway between two injections.Results  The number of deficiencies of the other pituitary functions (PD) was significantly higher in the groups that underwent RT (groups 1 and 5) than in the other groups; in both cases, P < 0·01. No significant differences were observed with regard to the mean GH, IGF‐I, ALS or IGFBP‐3 among the different treatment groups. A significant difference in the GH nadir was found between groups 2 and 4 (P = 0·042) and between groups 3 and 4 (P = 0·015). GH CV showed lower values in subjects who underwent RT (groups 1 and 5) than in the other groups. The difference was statistically significant between group 5 and groups 2, 3 and 4 (P < 0·05), between group 1 and groups 3 and 4 (P < 0·05), and between groups 2 and 4 (P = 0·007).Conclusions  Our data confirm that radiation therapy decreases GH variability, and that this effect is probably due to hypothalamic damage, as already reported by others. In irradiated patients, a single random sample should therefore be sufficient to evaluate spontaneous GH secretion.
Phase‐shifts of 24‐h rhythms of hormonal release and body temperature following early evening administration of the melatonin agonist agomelatine in healthy older men
Authors: Leproult Rachel , Van Onderbergen Anne , L’Hermite‐Balériaux Mireille , Van Cauter Eve , Copinschi Georges 
Published: August 2005

SummaryObjective  Older adults are less responsive to the phase‐shifting effects of light than younger subjects and may have difficulties adapting to abrupt time shifts. This study aims to determine whether the potent melatonin agonist agomelatine (S‐20098) is capable of phase‐shifting overt circadian rhythms in older adults.Subjects and design  Eight healthy elderly men participated in a double‐blind, two‐period, cross‐over study of 15 days of daily administration of either agomelatine (50 mg) or placebo at 1830 h.Measurements  At the end of each treatment period, the 24‐h profiles of body temperature and of the plasma levels of GH, PRL, cortisol and TSH were collected and sleep was monitored polygraphically.Results  Phase‐advances, averaging nearly 2 h, were observed for the temperature profile and for the variables characterizing the temporal organization of cortisol secretion following agomelatine administration. A similar trend was observed for the circadian rise of plasma TSH. There was no effect of agomelatine on any of the sleep variables. Agomelatine stimulated GH secretion during the wake period and was associated with a transient elevation of PRL levels.Conclusions  Melatonin agonists such as agomelatine may be useful to phase‐shift at least some overt circadian rhythms in older adults.
Erythropoietin administration does not influence the GH–IGF axis or makers of bone turnover in recreational athletes
Authors: Nelson A. E. , Howe C. J. , Nguyen T. V. , Seibel M. J. , Baxter R. C. , Handelsman D. J. , Kazlauskas R. , Ho K. K. 
Published: August 2005

SummaryObjective  Measurement of biochemical markers of the IGF‐system and of collagen turnover is a potential approach to detect GH abuse in sport. These markers are increased in patients on dialysis treated with recombinant human erythropoietin (r‐HuEPO), mimicking the effects of GH. The aim was to determine whether r‐HuEPO induces similar effects on the IGF‐system and collagen turnover in healthy athletes.Subjects and measurements  Young male Caucasian recreational athletes were administered 50 U/kg r‐HuEPO (n = 14) or placebo (n = 16) three times a week for 25 days, followed by a 4‐week wash‐out period. IGF‐I, IGFBP‐3, the acid labile subunit (ALS), N‐terminal propeptide of type I collagen (PINP), C‐terminal telopeptide of type I collagen (ICTP) and N‐terminal propeptide of type III collagen (PIIINP) were measured in samples collected at baseline (two samples), after 10, 22 and 24 days of r‐HuEPO treatment and at the end of the 4‐week wash‐out period.Results  Treatment with r‐HuEPO resulted in approximately threefold elevation of serum EPO and marked elevation of markers of erythropoiesis. There was no significant treatment effect of r‐HuEPO compared to baseline on IGF‐I, IGFBP‐3, ALS, PINP, ICTP or PIIINP.Conclusions  r‐HuEPO administration did not change markers of the IGF‐system and of collagen turnover in young healthy male athletes. Therefore, use of r‐HuEPO in athletes should not affect the validity of a GH doping test using these GH‐responsive markers.
Effects of 10 years of growth hormone (GH) replacement therapy in adult GH‐deficient men
Authors: Arwert Lucia I. , Roos Jan C. , Lips Paul , Twisk Jos W. R. , Manoliu Radu A. , Drent Madeleine L. 
Published: August 2005

SummaryObjective  GH‐deficient adults have changes in body composition, bone mineral density (BMD) and lipid profile that can be altered by GH substitution. However, long‐term data on GH substitution (up to 10 years of follow‐up) are limited.Design  The effects of 10 years of GH replacement therapy on BMD, body composition, bone parameters, serum lipids and glucose metabolism were studied.Patients  Twenty‐three childhood‐onset GH‐deficient men (mean age at baseline 28·6 years) were studied during 10 years of GH substitution therapy. A group of 19 age‐matched healthy men served as a control group for BMD measurements at baseline and after 10 years.Results  BMD of the lumbar spine increased during the 10 years of GH therapy. Bone markers and BMD in the hip increased during the first 5 years of GH therapy, but were not different from baseline after 10 years. BMD changes over time in the lumbar spine and femoral neck were significantly different in the patients compared to the controls. After 10 years the difference between the groups had decreased, but BMD was still higher in the controls than in the patients. Lipid profile had improved after 10 years of GH therapy, but body mass index (BMI), waist–hip ratio (WHR), fasting glucose and glycosylated haemoglobin (HbA1c) had increased compared to baseline.Conclusions  This long‐term follow‐up study found that 10 years of GH substitution in GH‐deficient men causes sustained improvements in BMD in the lumbar spine and lipid profile but not in body composition.