bluuebunny/crossref_metadata_2025_split huggingface dataset:
Refractive errors and visual impairment in 900 adults with intellectual disabilities in the Netherlands
Authors: Van Splunder Jacques , Stilma Jan S. , Bernsen Roos M. D. , Arentz Trudy G. M. H. J. , Evenhuis Heleen M. 
Published: May 2003

Abstract.Purpose:  To collect data on refractive errors and visual impairment in adults with an intellectual disability (ID) in the Netherlands.Patients:  A randomized sample of 2100 participants was drawn from a base population of 9000 adults with intellectual disabilities in the Netherlands. This article reports on the first 900 participants.Methods:  All participants underwent a protocol‐based on‐site ophthalmological assessment carried out by skilled investigators.Results:  Co‐operation was classified according to the number of tests that could be carried out reliably and was good or excellent in 80% of subjects, average in 13% and poor in 7%. Refraction could be reliably assessed in 505/900 (56%) subjects. There was an increased risk of visual impairment in all subgroups compared to the general Dutch population. Visual acuity (VA) was related to the level of ID, but refractive errors were not. New spectacles were prescribed in 106 cases (12%). Of 374 people in whom both monocular VA and the refractive error of the right eye could be reliably assessed, 153 (41%) had a pretest prescription, 16 (10%) of which we found to be inadequate. Of the 221 participants without a pretest prescription, 41 (19%) benefited from correction. Only 38/84 (45%) subjects aged 50 years or older, who could benefit from correction for near vision, had near spectacles. New correction increased the mean distant VA significantly from 0.44 to 0.65 (p < 0.0005).Conclusions:  With some adaptations, visual screening is feasible in a majority of adults with ID. Visual impairment and refractive errors are much more prevalent in adults with ID than in the normal population. Accurate spectacle correction resulted in significant improvement in distant VA.
The effect of vitamin E on stress‐induced changes in visual evoked potentials (VEPs) in rats exposed to different experimental stress models
Authors: Yargiçoğlu Piraye , Yaraş Nazmi , Ağar Aysel , Gümüşlü Saadet , Bilmen Süreyya , Özkaya Gül 
Published: May 2003

Abstract.Purpose:  The aim of the study was to investigate the effects of vitamin E on stress‐induced changes in visual evoked potentials (VEPs) and lipid peroxidation.Methods:  Eight experimental groups of 10 rats per group were formed. These consisted of the control group (C); the group treated with vitamin E (E); groups exposed to cold stress (CS), immobilization stress (IS) and both cold and immobilization stress (CIS), and groups exposed to equivalent stresses and treated with vitamin E (CSE, ISE, CISE). Vitamin E was injected intramuscularly in a dose of 30 mg/kg/day.Results:  Following chronic stress (15 days), plasma corticosterone concentrations in all experimental groups were significantly increased over those in C group. Vitamin E significantly decreased corticosterone levels in all stress groups compared with their respective control groups. Brain nitrite levels were significantly more elevated in all stress groups than in the C group. Vitamin E reduced retina and brain nitrite levels in all stress and E groups compared with their respective control groups. Vitamin E decreased glutathione peroxidase (GSH‐Px) activity in retina and brain tissues in the CSE group, but increased it in the ISE group compared with their respective control groups. Lipid peroxidation was increased in brain and retina tissues in all stress groups as indicated by the significant increase in thiobarbituric acid‐reactive substance (TBARS) levels with respect to the C group. Vitamin E produced a significant decrease in brain and retina TBARS levels in all stress groups with respect to their corresponding control groups. The mean latencies of P1, N1, P2, N2 and P3 components were significantly prolonged in all stress groups compared with the C group.Conclusion:  Vitamin E returned the VEP latencies in the stress groups to control values. Our findings clearly indicated that vitamin E has the potential to prevent VEP changes caused by stress.
Topical α‐interferon in recurrent conjunctival papilloma
Authors: De Keizer R. J. W. , De Wolff‐Rouendaal D. 
Published: May 2003

Abstract.Purpose:  To report the effect of topical α‐interferon (α‐IF) in two cases of recurrent conjunctival papillomas.Methods:  One patient with a conjunctival papilloma and one patient with a limbus‐based papilloma were treated with excision and cryotherapy. Recurrences included one in situ carcinoma. Retreatment included systemic and topical α‐IF.Results:  In Case 1, the papillomas regressed with systemic α‐IF followed by topical application of α‐IF (2.8 × 106 U) for 1 year against recurrence. In Case 2, the papillomas disappeared with topical α‐IF over 1 year. No recurrences were seen during follow‐up (84 and 91 months, respectively). The possible side effect of topical α‐IF was superficial keratitis. Retrospective polymerase chain reaction tests for HPV were positive and showed type 6 in Case 1 and type 33 in Case 2.Conclusion:  Topical α‐IF can be used as adjuvant therapy in recurrent conjunctival papillomas.
A psychopathological study into the relationship between attention deficit hyperactivity disorder in adult patients and recurrent brief depression
Authors: Hesslinger B. , Tebartz van Elst L. , Mochan F. , Ebert D. 
Published: May 2003

Objective: Clinical and epidemiological observations and neurobiological data suggest that there might be an inherent link between attention deficit hyperactivity disorder (ADHD) and recurrent brief depression (RBD). In this psychopathological study, we investigated the comorbidity between these two conditions.Method: Using an index patient approach 40 adult out‐patients fulfilling the criteria for ADHD were investigated for lifetime history of RBD and another 40 out‐patients with the primary diagnosis of RBD were investigated for a lifetime history of ADHD.Results: We found a high prevalence of RBD in patients with ADHD (70%) while the prevalence of ADHD in the index sample with RBD was smaller (about 40%).Conclusion: In terms of comorbidity ADHD was the second commonest psychiatric disorder in patients with RBD next to other affective disorders. The psychopathological pattern of lifetime comorbidity might be of clinical relevance in terms of medical treatment.
Aging and outcome in schizophrenia
Authors: Jeste D. V. , Twamley E. W. , Eyler Zorrilla L. T. , Golshan S. , Patterson T. L. , Palmer B. W. 
Published: May 2003

Objective:  Controversy exists about long‐term outcome of schizophrenia, but few studies have compared older out‐patients to normal subjects. We sought to examine the relationship of age to clinical features, psychopathology, movement abnormalities, quality of well‐being, and everyday functioning in schizophrenia out‐patients and normal comparison subjects, and to further characterize these outcomes in elderly schizophrenia out‐patients.Method:  A total of 290 out‐patients and 144 comparison subjects, aged 40–85 years, underwent comprehensive assessments.Results:  Among patients, aging was associated with decreased psychopathology, even after controlling for duration of illness. There was no accelerated aging‐related decline on any measure in the patients. Yet, elderly patients were more impaired than comparison subjects on various measures.Conclusion:  The course of schizophrenia in late life appears stable, but most elderly patients remain symptomatic and impaired. Our findings dispute notions of either progressive deterioration or marked improvement in aging schizophrenia out‐patients.
Sites of recurrence in oral and oropharyngeal cancers according to the treatment approach
Authors: Carvalho AL , Magrin J , Kowalski LP 
Published: May 2003

OBJECTIVE: The purpose of this study is to evaluate the rates and the sites of tumour recurrence in patients with oral and oropharyngeal carcinomas.DESIGN: This is a retrospective study of a series of cases treated in a single institution.PATIENTS AND METHODS: A series of 2067 patients with oral and oropharyngeal squamous carcinoma, treated from 1954 to 1998 were analysed. The treatment approach was: surgery, 624 cases (30.2%); radiotherapy alone, 729 cases (35.3%); radiotherapy and surgery, 552 cases (26.7%) and radiotherapy and chemotherapy, 162 cases (7.8%).MAIN OUTCOME MEASURES: Tumour recurrence was observed in 1079 patients (52.2%): 561 cases of local recurrences (27.1%); 168 neck recurrences (8.1%); 252 locoregional recurrences (12.2%); 59, distant metastasis (2.9%) and 39 (1.9%), combination of distant metastasis with local, neck or locoregional recurrence.RESULTS: The rates of recurrence varied significantly according to the treatment performed. Oral cavity cancer patients undergoing radiotherapy alone or in combination with chemotherapy presented the highest rates of neck recurrences (22.5 and 40.0%, respectively) for clinical stage (CS) I/II and of local (41.2 and 30.1%) and locoregional (21.7 and 31.1%) recurrences for CS III/IV; yet, for CS III/IV, surgery without neck dissection was associated with the highest rates of neck recurrences (20.7%), but no differences were observed in the rates of local or locoregional recurrences for CS I/II patients. For oropharynx cancer patients with CS I/II there was no difference in the rate of locoregional failures according to the treatment. However, patients with CS III/IV undergoing radiotherapy present a highest rate of local (42.3%) and locoregional (28.8%) failures.CONCLUSION:The results suggest that surgery should be the first option for initial clinical stage oral and oropharyngeal cancers. For advanced cases independently of the site of the tumour, surgery and postoperative radiotherapy should be the standard of care because it is associated with the lowest rates of locoregional recurrence.
Evaluation of serum sialic acid, sialyltransferase and sialoproteins in oral cavity cancer
Authors: Raval GN , Patel DD , Parekh LJ , Patel JB , Shah MH , Patel PS 
Published: May 2003

OBJECTIVE:Altered glycosylation of glycoconjugates is among the important molecular changes that accompany malignant transformation. The aim of our study was to investigate clinical usefulness of circulatory levels of sialic acid, sialoproteins and sialyltransferase for early diagnosis and management of oral cavity cancer (OC) patients.MATERIALS AND METHODS:Blood samples collected from 210 untreated OC patients, 100 patients with oral precancerous conditions (OPC) and 100 healthy males. OC patients were followed after initiation of anticancer treatment and 394 follow‐up samples were also collected. Serum sialic acid levels were measured spectrophotometrically. Sialyltransferase activity was analysed using radioassay.α2‐6 sialoproteins were isolated using lectin affinity chromatography.RESULTS:Serum levels of free, protein bound and total sialic acid as well as their ratio with total proteins were significantly elevated in untreated OC patients compared with healthy individuals, patients with OPC as well as complete responders (CR). Levels of the markers were comparable between untreated OC patients and non‐responders. We observed positive correlation between serum levels of the markers and extent of malignant disease. Serum sialyltransferase activity showed significant elevations in OC patients compared with the controls (P<0.001), patients with OPC (P<0.05) and CR (P<0.05). Higher sialic acid levels in OC patients at the time of diagnosis showed poor survival. The changes in serum proteins with terminalα2‐6 sialic acid correlated well with the alterations in the levels of sialic acid forms and sialyltransferase activity.CONCLUSION:Our results confirmed the elevations in sialic acid and sialyltransferase levels in OC patients and suggested potential utility of these parameters in prognostication and treatment monitoring of this neoplasm. The alterations in these parameters in circulation were in accordance with the changes inα2‐6 sialylated proteins.
In vitro and in vivo responses to short‐term recombinant human insulin‐like growth factor‐1 (IGF‐I) in a severely growth‐retarded girl with ring chromosome 15 and deletion of a single allele for the type 1 IGF receptor gene
Authors: De Lacerda Luiz , Carvalho Julienne A. R. , Stannard Bethel , Werner Haim , Boguszewski Margaret C. S. , Sandrini Romolo , Malozowski Saul N. , LeRoith Derek , Underwood Louis E. 
Published: May 2003

OBJECTIVESPatients with single allele defects in the gene encoding the type 1 IGF receptor have been reported to have growth failure, but fibroblasts from affected patients have not exhibited insensitivity to the effects of IGF‐I in vitro. The in vitro and in vivo responses to short‐term recombinant human IGF‐I (rhIGF‐I) in a severely growth‐retarded girl with ring chromosome 15 and deletion of a single allele for the type 1 IGF receptor gene have been investigated.DESIGN AND PATIENTThe child exhibited prenatal and severe post‐natal growth failure, and delayed psychomotor development. Southern blotting revealed a 50% reduction in IGF‐I receptor DNA, and in an RNase protection assay (RPA), a quantitatively similar reduction in steady‐state mRNA for type 1 IGF receptor. rhIGF‐I was administered in graded doses of 40, 60 and 80 μg/kg twice daily by subcutaneous injection for periods of 2–2.5 days each.RESULTSDuring rhIGF‐I treatment, mean urinary nitrogen excretion was unchanged and urinary calcium rose to 60% greater than in the pre‐treatment period. rhIGF‐I injections produced only a modest decrease in indices of GH secretion, assessed by frequent (every 20 min) sampling over periods of 12 h. There was no significant difference between the mean GH concentrations during rhIGF‐I treatment (5.32 ± 6.2 mU/l) compared with that before rhIGF‐I treatment (8.46 ± 10.2 mU/l). Mean IGFBP‐3‐values were increased (4.5 mg/l before vs. 5.4 mg/l during rhIGF‐I). TSH values after injection of TRH were not significantly reduced by IGF‐I (mean of all values, 18.6 mU/l vs. 15.5 mU/l during rhIGF‐I treatment). In vitro binding of radiolabelled IGF‐I to the patient's fibroblasts was less than that bound by control fibroblasts (patient, 0.69% binding by 248 000 cells, vs. 1.41% binding by 260 000 fibroblasts from an age‐matched control). However, the patient's fibroblasts exhibited a growth response in vitro to the addition of IGF‐I in a fashion similar to that of control fibroblasts.CONCLUSIONSThese studies show evidence in each of the indices examined of in vivo resistance to IGF‐I and suggest that the growth retardation observed in such patients may be the direct result of the absence of one of the alleles encoding the type 1 IGF receptor.
Serum leptin and body composition in children with familial GH deficiency (GHD) due to a mutation in the growth hormone‐releasing hormone (GHRH) receptor
Authors: De A. Barretto Elenilde S. , Gill Matthew S. , De Freitas Maria E. S. , Magalhães Marta M. G. , Souza Anita H. O. , Aguiar‐Oliveira Manuel H. , Clayton Peter E. 
Published: May 2003

OBJECTIVEThe relationship between GH, body composition and leptin in children remains ill‐defined. We have therefore examined the impact of severe GH deficiency (GHD) due to a mutation in the GHRH receptor on serum leptin concentrations and body composition in childhood.PATIENTS12 affected children and young people (GHD) (4 M:8F, age 5.4–20.1 years, 8 Tanner stage (TS) 1–2, 4 TS 3–5) and 40 healthy controls (C) from the same region (13 M:27F, age 5.3–18.4 years, 20 TS 1–2, 20 TS 3–5).METHODSPercent body fat was determined by infra‐red interactance, from which the amounts of fat mass (FM, kg) and fat free mass (FFM, kg) were derived. Serum leptin concentrations were measured in a single fasted, morning serum sample and results expressed as a concentration and as leptin per unit fat mass (L/FM, ng/ml/kg). To control for differences in sex and pubertal maturation, leptin standard deviation scores (leptin SDS) were calculated using normative data from UK children.RESULTSFFM was significantly lower in GHD children than in controls (TS 1–2 P < 0.05, TS 3–5 P < 0.001). FM did not differ significantly between the two groups. Serum leptin concentrations, leptin per unit fat mass and leptin SDS were significantly elevated in GHD children both peripubertal and pubertal compared with controls. Using all subjects, stepwise multiple linear regression with FM, FFM, age, puberty and sex as explanatory variables and leptin concentration as the dependent variable indicated that 59% of the variability in leptin could be accounted for by FM (+ , 45%), FFM (− , 9%) and sex (+ , 5%) (P < 0.001). However on inclusion of GH deficiency (coded GHD = 1, control = 2) as an explanatory variable 73% of the variability in leptin was explained by FM (+ , 45%), GHD (− , 22%) and sex (+ , 6%) (P < 0.001).CONCLUSIONSThese data indicate that severe GH deficiency in children is associated with elevated leptin concentrations, irrespective of sex or pubertal stage. This increase is not associated with differences in fat mass but is related to reduced fat free mass in GH deficiency. Furthermore in this population there may be an additional effect of GH deficiency on leptin, independent of the influences of sex and body composition.
High serum leptin levels in children with type 1 diabetes mellitus: contribution of age, BMI, pubertal development and metabolic status
Authors: Luna Reyes , Garcia‐Mayor Ricardo V. , Lage Mary , Andrade M. Amalia , Barreiro Jesús , Pombo Manuel , Dieguez Carlos , Casanueva Felipe F. 
Published: May 2003

OBJECTIVEChildren with diabetes mellitus are prone to develop obesity and to experience a delay in onset of the pubertal process. In order to understand the role of leptin in these abnormalities, serum leptin levels were analysed in children with type 1 diabetes mellitus.SUBJECTSTwenty diabetic girls, 23 diabetic boys and 66 healthy children (selected from a reference population of 706 normal children), age‐, sex‐ and BMI‐matched with diabetic patients, were studied.MEASURMENTSStanding height, weight and BMI were determined in each child. Serum testosterone, oestradiol and leptin were measured by specific radioimmunoassays, and HBA1c by high performance liquid chromatography.RESULTSBoth diabetic girls and boys showed higher leptin levels than the normative healthy population and a group of age‐, sex‐ and BMI‐matched normal children. In an age‐related analysis, leptin levels in diabetic girls rose from 7.4 ± 1.2 and 8.1 ± 2.1 μg/l for the 5–7.99 and 8–10.99 year groups, to 12.6 ± 2.4 μg/l for the 11–13.99 year group, and to 15.6 ± 4.0 μg/l in the 14–15.99 year group in parallel with body weight. Leptin concentrations were parallel but higher (P < 0.05) than those of healthy girls. Diabetic boys had lower leptin levels than girls and, in contrast with normal boys, did not show a drop after the 10‐year period. Leptin levels were 4.9 ± 2.2, 3.9 ± 0.2, 5.5 ± 0.6 and 5.1 ± 0.9 μg/l for the 5–7.99, 8–10.99, 11–13.99 and 14–15.99 year groups, respectively. When divided by pubertal stage, leptin levels in the prepuberty stage of diabetic girls (8.6 ± 1.0 μg/l) were higher (P < 0.05) than those in the controls (4.1 ± 0.4 μg/l). In overt puberty girls, leptin was higher (P < 0.05) for diabetic (15.9 ± 2.9 μg/l) than for healthy girls (9.2 ± 1.1 μg/l). In prepubertal boys, differences were observed in leptin levels (4.9 ± 0.5 μg/l for diabetic boys and 3.4 ± 0.6 μg/l for healthy boys). In the overt puberty stage, diabetic boys showed higher (P < 0.05) levels of leptin (5.2 ± 0.7 μg/l) than the healthy matched controls (2.1 ± 0.2 μg/l). A multiple step regression analysis in the diabetic children revealed no associations between leptin and other relevant variables such as glycosylated haemoglobin, daily insulin dose, or years of suffering from the disease.CONCLUSIONSerum leptin levels were higher in diabetic than in healthy children. These differences were not attributable to age, adiposity or stage of pubertal development, and were probably conditioned by the metabolic perturbation intrinsic to the diabetic state, or the chronic hyperinsulinemia.
The 1μg short Synacthen test in chronic fatigue syndrome
Authors: Hudson Marina , Cleare Anthony J. 
Published: May 2003

OBJECTIVEMany studies suggest mild hypocortisolism in chronic fatigue syndrome (CFS), usually assumed to be due to reduced suprahypothalamic drive to the hypothalamo‐pituitary‐adrenal (HPA) axis. We wished to explore further the state of the HPA axis in CFS using the 1 μg low dose short Synacthen test.DESIGNSubjects received an intravenous bolus of 1 μg Synacthen; samples for cortisol estimation were taken at baseline and 2, 10, 20, 30, 40 and 60 minutes after injection.PATIENTSWe tested 20 subjects suffering from CFS according to the criteria of the Center for Diseases Control without psychiatric comorbidity and 20 matched healthy controls. All subjects were drug free for at least 1 month.MEASUREMENTSWe calculated the cortisol responses to the test as the maximum cortisol attained, the incremental rise in cortisol over baseline (Δvalue) and as the integrated area under the curve.RESULTSThere were no significant differences in baseline cortisol or cortisol responses between patients and controls. However, responses generally were low, and many subjects' peak responses were prior to the standard 30 minute sampling time., CONCLUSIONS These results do not lend support to the theory that patients with chronic fatigue syndrome have a low adrenal reserve. However, results from studies assessing the HPA axis are proving to be inconsistent. We suggest that many other factors may be contributing to HPA axis alterations in chronic fatigue syndrome, including sleep disturbance, inactivity, altered circadian rhythmicity, illness chronicity, concomitant medication and comorbid psychiatric disturbance. These sources of heterogeneity need to be considered in future studies, and may explain the inconsistent findings to date.
Patients' readiness for dietary change at the beginning of counselling: a transtheoretical model‐based assessment
Authors: Kasila K. , Poskiparta M. , Karhila P. , Kettunen T. 
Published: May 2003

AbstractBackground  The purpose of this study was to explore patients' readiness for dietary change within a theoretical framework of the transtheoretical model. The patients were recently diagnosed to have type 2 diabetes or impaired glucose tolerance. We discuss the theoretical aspects of appropriate dietary counselling strategies from a standpoint of patient‐specific stages of change.Methods  The data included 32 audiotaped diabetes counselling sessions with 16 patients conducted by two nurses. The transcribed data was analysed by using deductive content analysis.Results  The patients were at different stages of change of diabetes‐affected dietary behaviour. Their stages of change varied in different dietary areas and within certain dietary habits. These stages of change could involve their overall dietary behaviour or some minor aspects of their diets.Conclusions  Understanding patient‐specific stages of change orientates health counsellors to use the most appropriate counselling strategies. The transtheoretical framework helps counsellors to perceive the total range of patients' different stages of change and their effect on the implementation of counselling. However, determining patients' stages of change through examining counselling conversations is occasionally difficult. Further qualitative research is called for.