bluuebunny/crossref_metadata_2025_split huggingface dataset:
De novominimal change disease associated with reversible post‐transplant nephrotic syndrome. A report of five cases and review of literature
Authors: Zafarmand Alireza A , Baranowska‐Daca Elzbieta , Ly Peter DC , Tsao Chun C , Choi Yeong‐Jin , Suki Wadi N , Truong Luan D 
Published: March 2003

Zafarmand AA, Baranowska‐Daca E, Ly PDC, Tsao CC, Choi Y‐J, Suki WN, Truong LD.De novominimal change disease associated with reversible post‐transplant nephrotic syndrome. A report of five cases and review of literature. Clin Transplant 2002: 16: 350–361. © Blackwell Munksgaard, 2002Nephrotic syndrome (NS) is frequent in renal transplant recipients and may be related to a large variety of glomerular lesions. In some of these cases, the transplant biopsy showed no significant glomerular changes and the NS was reversible, but the primary renal disease was not minimal change disease (MCD), suggesting that MCD may developde novoin renal transplant setting. Knowledge of this entity, however, is limited. Among 67 cases of post‐transplant NS encountered in a 12‐yr period, five were found to be associated withde novoMCD.A critical review of the literature revealed nine additional cases ofde novoMCD. The data from these 14 cases show that patients withde novoMCD had a large variety of primary renal diseases but MCD or focal segmental glomerulosclerosis was not among them. Eight of the 14 transplanted kidneys (60%) were from living related donors, suggesting this as a risk factor. Nephrotic range proteinuria (3–76 g/d) developed immediately or shortly after transplantation (within 4 months for all reported cases, except for one at 24 months). The serum creatinine when NS was first diagnosed was normal or mildly elevated, but acute renal failure occurred in three patients. On biopsy, the glomeruli were normal or, more frequently, displayed mild, focal segmental mesangial sclerosis, hypercellularity, deposition of IgM/C3, or accumulation of mononuclear inflammatory cells in some glomerular capillaries. The tubulointerstitial compartment was normal in cases with normal renal function; displayed mild acute and/or chronic rejection that correlated with a mildly elevated serum creatinine; or showed acute changes including acute rejection, acute tubular necrosis, or acute cyclosporin A toxicity, which accounted for both acute renal failure at presentation and its subsequent reversibility.Under various treatments, including increased steroids, angiotensin converting enzyme inhibitors, calcium channel blockers and angiotensin receptor blockers, sustained remission of NS was achieved in 13 cases, within a year (0.5–12 months) in 10 and later (24, 34 and 98 months, respectively) in three. In the remaining case, the patient died of septic shock 2 months after transplantation. After remission of the NS, the grafts functioned well without or with minimal proteinuria for several years.De novoMCD has characteristic clinical and pathologic features.It represents an important but hitherto underemphasized cause of post‐transplant NS, which is potentially reversible and does not adversely affect the renal transplants.
Urodynamic testing predicts long‐term urological complications following simultaneous pancreas–kidney transplantation
Authors: Blanchet Pascal , Droupy Stéphane , Eschwege Pascal , Hammoudi Yacine , Durrbach Antoine , Charpentier Bernard , Benoit Gérard 
Published: March 2003

Abstract: Introduction: Combined pancreas–kidney transplantation is the treatment of choice for patients with type I diabetes mellitus associated with chronic renal failure. The introduction of the bladder drainage technique constituted a marked improvement of the surgical technique with a reduction of life‐threatening complications. However, drainage of pancreatic secretions via the urinary bladder causes urological complications leading, in some cases, to cystoenteric conversion. We retrospectively analysed whether pre‐operative urodynamic findings may predict the subsequent development of urological complications and influence the choice of exocrine secretion drainage.Patients and methods: From 1987 to 1997, 39 bladder‐drained simultaneous pancreas–kidney transplantations were performed in 16 men and 23 women with a mean age of 38.5 yr. All patients underwent a complete urological assessment prior to surgery, including medical history, physical examination, urethrocystography and urodynamic assessment.Results: Twenty‐eight patients are alive with a mean follow‐up of 62 ± 8 months. In 60% of cases, both kidney and pancreas remain functional. Seven patients experienced recurrent lower urinary tract infections. Six patients suffered from chemical urethritis (four men and two women) and six suffered from recurrent haematuria (blood transfusions were required in two patients). One patient had incrusted stones at the site of duodenal staples. Urological complications were mostly observed in the 22 patients (79%) with abnormal urodynamic characteristics (Relative risk: 5.1). Intravenous Somatostatin®failed to definitively cure these complications in most cases. Seven patients (17%) (five with urethritis, two with haematuria) required cystoenteric conversion. Two patients developed post‐operative ileal fistula, one cutaneous and one into the bladder. All urinary symptoms resolved in these seven patients.Conclusion: The frequency of specific urinary complications is high (28%) in bladder‐drained simultaneous pancreas–kidney transplantation patients. These complications are statistically more frequent in the case of an abnormal pre‐transplant urodynamic assessment.
Predominant factors associated with bone loss in liver transplant patients – after prolonged post‐transplantation period
Authors: Segal Elena , Baruch Yakov , Kramsky Rimma , Raz Batia , Tamir Ada , Ish‐Shalom Sophia 
Published: March 2003

Abstract: Introduction: Osteoporosis is a major cause of morbidity in liver transplant recipients and is associated with multiple factors.Objectives: To evaluate bone mineral density (BMD), bone turnover and calcium‐regulating hormones in 29 patients (17 men, 12 women) 2–12 yrs following liver transplantation for non‐alcoholic liver diseases.Results: Fifteen patients (52%) were on immunosuppressive treatment with tacrolimus and 14 (48%) with cyclosporine. Eleven patients (38%) were currently on prednisone, 18 patients (62%) had stopped glucocorticoid treatment 6 months to 11 yrs prior to the study. Nineteen patients (65.5%) had decreased BMD according to WHO criteria, 17 (58.2%) at the femoral neck, 13 (44.8%) at the lumbar spine. Nineteen patients (65.5%) had a subnormal (<15 ng/mL) serum level of 25 (OH) D3. These patients had significantly lower BMD at the femoral neck (p = 0.02). Femoral neck BMD negatively correlated with serum parathyroid hormone level (p = 0.06, r = −0.35), length of the post‐transplantation period (p = 0.025, r = −0.416) and duration of glucocorticoid treatment (p = 0.029, r = −0.406), regardless of its cumulative dose. Symptomatic fractures were less frequent in tacrolimus treated patients than in cyclosporine users (p = 0.03).Conclusions:  Decreased BMD is frequent following liver transplantation and is affected by vitamin D deficiency, cyclosporine use, and the duration of glucocorticoid therapy, but not by its cumulative dose. Achievement and maintenance of optimal vitamin D status and shortening of glucocorticoid treatment period may have a favorable effect on bone preservation.
Individualized T cell monitored administration of ATG versus OKT3 in steroid‐resistant kidney graft rejection
Authors: Midtvedt Karsten , Fauchald Per , Lien Bjoern , Hartmann Anders , Albrechtsen Dagfinn , Bjerkely Birgitte L. , Leivestad Torbjoern , Brekke Inge B. 
Published: March 2003

Abstract: Acute steroid‐resistant rejection episodes are recommended to be treated with set doses of anti‐thymocyte globulin (ATG) or anti‐CD3 monoclonal antibody (OKT3). Individualized T cell monitoring has been proposed as a tool for dose finding. A randomized study comparing the efficacy and safety of ATG (n = 27) with OKT3 (n = 28) in the treatment of biopsy verified acute steroid‐resistant rejection (ASRR) when both drugs were administered on the basis of daily individualized T cell measurements. A drop to below 50 cells/mm3 CD2+ T cells was considered adequate and used to guide the dose of ATG/OKT3. Demographic, clinical and histopathological severities of rejections were equal in the two groups. During the 10 days of T cell monitoring and antibody treatment, 13 patients were in need of dialysis (ATG = 7/OKT3 = 6). Two grafts did not respond to antibody treatment and were lost due to rejection (ATG = 1/OKT3 = 1). There were 26 biopsy verified re‐rejections (ATG = 12/OKT3 = 14) within the first 3 months following antibody treatment. Mean serum creatinine (μmol/L) was similar in the two groups (ATG/OKT3: before rejection 157 ± 72/151 ± 88, at start of antibody treatment 308 ± 125/330 ± 94, end of antibody treatment 254 ± 122/246 ± 144 and at follow‐up after a mean of 32 months 166 ± 55 (n = 24)/164 ± 57(n = 23)). To keep the T cell count below 50 cells/mm3, average dose ATG given was 354 ± 151 mg (2.3 administrations, range 1–4) and average OKT3 was 32.5 ± 6.8 mg in 10 doses. In conclusion, individualized T cell monitored administration of ATG and OKT3 is safe and seems as effective as a standard set dose in treatment of ASRR. Tailoring the dose for each individual patient lowers the cost.
Impact of substance abuse on the course and treatment of bipolar disorder
Authors: Salloum Ihsan M , Thase Michael E 
Published: March 2003

Objectives:

The objectives of this article are to review the prevalence, natural history, pathophysiology, and treatment of comorbid bipolar disorder with alcoholism and other psychoactive substance use disorders (PSUDs).

Methods: All identified bibliographies through a literature search of all Medline files and bibliographies of selected articles focusing on the prevalence, natural history, course, prognosis, inter‐relationship, and treatment of bipolar disorder with comorbid alcoholism and other PSUDs were reviewed.

Results and conclusions: Comorbidity of bipolar disorder and alcoholism and other PSUDs is highly prevalent. The presence of this so called ‘dual diagnoses’ creates a serious challenge in terms of establishing an accurate diagnosis and providing appropriate treatment interventions. The inter‐relationship between these disorders appears to be mutually detrimental. The course, manifestation, and treatment of each condition are significantly compounded by the presence of the other condition. Substance abuse and alcoholism appear to significantly complicate the course and prognosis of bipolar disorder resulting in increased suffering, disability, and costs. On the other hand, bipolar disorder may be a risk factor for developing PSUDs. Although, there are a number of hypotheses explaining the pathophysiological mechanism involved in such comorbidities, our understanding of the exact nature of such neurobiological mechanisms is still limited. While the antikindling agents and targeted psychotherapeutic techniques may be useful intervention strategies, there is still a significant lack of empirically based treatment options for these patients.
3′(2′)‐Phosphoadenosine 5′‐phosphate phosphatase is reduced in postmortem frontal cortex of bipolar patients
Authors: Shaltiel G , Kozlovsky N , Belmaker R H , Agam G 
Published: March 2003

Shaltiel G, Kozlovsky N, Belmaker RH, Agam G. 3′(2′)‐Phosphoadenosine 5′‐phosphate phosphatase is reduced in postmortem frontal cortex of bipolar patients. Bipolar Disord 2002: 4: 302–306. © Blackwell Munksgaard, 2002
Objective:
3′(2′)‐Phosphoadenosine 5′‐phosphate (PAP) phosphatase is a novel lithium (Li) inhibitable enzyme. Thus the enzyme seemed an important candidate for studies of the molecular etiology of bipolar disorder.
Methods:
RT–PCR, Western‐blot analysis and Pi liberation were used to measure PAP phosphatase mRNA levels, protein levels and enzyme activity (respectively) in postmortem frontal cortex specimens of bipolar patients versus normal subjects.
Results:
The PAP phosphatase protein levels were 24% significantly lower in bipolar patients than in normal subjects. PAP phosphatase mRNA levels and enzymatic activity did not differ between normal controls and bipolar patients.
Conclusions:
Abnormality of PAP phosphatase in bipolar patients offers a new direction for study of bipolar disorder etiology.
Serotonergic dysregulation in bipolar disorders: a literature review of serotonergic challenge studies
Authors: Sobczak S , Honig A , Van Duinen MA , Riedel WJ 
Published: March 2003

Objectives:  Serotonin (5‐hydroxytryptamine; 5‐HT) and endocrine abnormalities have been repeatedly reported in bipolar disorders (BD). Useful methods to investigate 5‐HT responsivity, and the interaction with neuroendocrine functioning, are provided by acute 5‐HT challenge and depletion paradigms. In this review 5‐HT challenges are limited to paradigms that stimulate 5‐HT activity in BD.Methods:  Literature was searched for in electronic libraries: MEDLINE and PSYCHLIT, period 1966–2001. Papers describing effects of an acute 5‐HT challenge on neuroendocrine functioning in BD patients were selected.Results:  Review of the literature revealed 15 studies: five papers described the effects of 5‐HT challenges in manic BD patients, four papers in euthymic BD and seven in depressed BD patients. The reviewed 5‐HT challenge paradigms are acute administration of oral and intravenous (i.v.) dosage of d,l‐fenfluramine, tryptophan, 5‐hydroxytryptophan, ipsapirone and buspirone. There were no papers which investigated neuroendocrine effects of m‐chlorophenylpiperazine, clomipramine and citalopram in BD patients and were therefore not reviewed.Conclusions:  The literature on 5‐HT challenge procedures in BD shows evidence for a blunted prolactin (PRL) in mania and depression as well as a blunted cortisol in euthymic BD patients. This suggests that in both mania and depression similar changes in the 5‐HT system are involved. It is speculated that blunting of cortisol responses in euthymic BD patients may be a result of chronically altered 5‐HT functioning, whereas changes in PRL release following 5‐HT challenges reflect more state‐dependent changes in 5‐HT activity. The 5‐HT responsivity in BD patients has also been associated with pharmacological treatment, suicidal behaviour, weight loss and age. Recommendations for future research are given.
Acute antimanic efficacy and safety of oxcarbazepine in an open trial with an on‐off‐on design
Authors: Hummel Barbara , Walden Joerg , Stampfer Robert , Dittmann Sandra , Amann Benedikt , Sterr Andrea , Schaefer Martin , Frye Mark A , Grunze Heinz 
Published: March 2003

Rationale and Objectives:  Carbamazepine has shown reasonable antimanic properties, but its use has been limited because of enzyme‐inducing effects. The keto‐derivative oxcarbazepine (OXC) is very similar to carbamazepine, however, the metabolic pathway is different. OXC is not metabolized to the 10, 11–epoxide, which seems to be responsible for several undesirable side‐effects of carbamazepine and furthermore OXC has less enzyme‐inducing properties.Methods:  In this non‐random open label study, patients were treated with OXC for 14 days, crossed over to no OXC for 7 days, and then crossed back over to OXC for the remaining 14 days. OXC was titrated to a final dose in a range of 900–2100 mg due to individual response. Treatment success was defined as a reduction of the original Young Mania Rating Scale (YMRS) score of more than 50% at the end of study period.Results:  Four of the 12 included patients (33%) met defined response criteria at the end of study period. Fifty percentage of the patients had to be prematurely excluded from the trial. The mean YMRS scores of the on‐periods were obviously different from the off‐period. Forty‐two percentage of the patients experienced side‐effects leading to premature discontinuation in two of 12 patients.Conclusion:  Antimanic activity of OXC was demonstrated in this pilot study only for patients with mild or moderate manic symptoms. Further studies are encouraged to clarify OXC's role as mood‐stabilizer and assess whether it has a profile similar to that of carbamazepine.
Oxcarbazepine treatment of refractory bipolar disorder: a retrospective chart review
Authors: Nassir Ghaemi S , Ko James Y , Katzow Jacob J 
Published: March 2003

Objective:
To determine if oxcarbazepine is effective as treatment for refractory bipolar illness in a naturalistic setting.

Methods: All charts of out‐patients treated with oxcarbazepine (n=13) were reviewed and clinical response assessed retrospectively using the Clinical Global Impression of Improvement (CGI‐I) rating scale. All patients had failed treatment with at least one previous mood stabilizer.

Results: Mild improvement was seen in 46% (n=6) and moderate improvement in 16% (n=2). Fifty‐four percent (n=7) of the total sample discontinued treatment because of adverse effects.

Conclusion: Oxcarbazepine may possess mild to moderate mood‐stabilizing properties in this refractory, mostly depressed, bipolar sample. This naturalistic study is limited by its uncontrolled nature.
Thermal endometrial ablation: a simple technique
Authors: SINGH KISHOR C. , SENGUPTA RINKU , AGARWAL NEERA , MISRA KIRAN 
Published: March 2003

Background. To evaluate the effectiveness and safety of a technique for thermal endometrial ablation.Method. The study was carried out in three steps; step I on 10 fresh uterine specimens, step II on 14 intact uteri during hysterectomy and step III in five patients, two weeks prior to hysterectomy. A simple device comprising a Foley catheter No. 14F, a three way cannula and a 20 cc syringe was used for the procedure. The balloon of the catheter was inflated within the uterine cavity with boiling normal saline for 9 minutes. Uterine cavity and serosal temperature was recorded during the procedure. Thermal injury was assessed by gross and histological examination of the specimens.Results. The mean maximum endometrial cavity temperature was 91° C whereas serosal temperatures in steps I and II were 34° C and 35.9°C respectively. None of the balloons ruptured in any of the steps and there were no complications. In 13 of 14 specimens in step II, there was a zone of hyperemia with a depth of 3 to 7 mm. The corresponding histological picture was extensive hemorrhage and fragmentation of glands throughout the endometrium including the cornual regions. Consistent findings were noted in step III in which all but one showed extensive coagulative necrosis of the whole of endometrium with edema of the underlying myometrium. There was a statistically significant positive correlation between the volume of fluid injected and depth of hyperemia.Conclusion. This technique could be a simple, effective, inexpensive and safe alternative to hysteroscopic endometrial ablation.
Prevalence of menstrual cycle symptom cyclicity and premenstrual dysphoric disorder in a random sample of women using and not using oral contraceptives
Authors: SVEINDÓTTIR HERDÍS , BÄCKSTRÖM TORBJÖRN 
Published: March 2003

Background. The prevalence of symptom cyclicity and premenstrual dysphoric disorder in randomly recruited samples of women has not been ascertained. We assessed this prospectively in 83 Icelandic women, aged 20–40 years, using and not using oral contraceptives (OCs).Methods. A check list of 57 symptoms, divided into 7 symptom groups, was used to assess experiences. All symptoms and summarized symptom scores within symptom groups were tested for significant change between the follicular and the luteal phase of each menstrual cycle. When a symptom or a summarized symptom score was higher during the luteal phase compared to the follicular phase the cyclicity is labelled ‘expected’ cyclicity and the opposite ‘unexpected’ cyclicity.Results. The women charted from 1–7 menstrual cycles each, with 66 of them charting 3–4 cycles. Cyclicity was never displayed by 9.6% of participants; 80.7% displayed expected cyclicity and 72.3% unexpected cyclicity at least once. Cyclicity in somatic symptoms was most often demonstrated by participants. Expected and unexpected cyclicity in summary symptom scores in well‐being and in psychoemotional symptoms was very similar among participants. There was not much difference in cyclicity between non OC users and OC users. Fifty‐one percent of the participants were self‐defined with premenstrual syndrome with 2%–6% of them meeting the criteria of premenstrual dysphoric disorder.Conclusions. The normalcy of cyclicity found in this study might explain the high prevalence of premenstrual syndrome in many recall surveys. The importance of prospective daily ratings for establishing symptom cyclicity in women cannot be over emphasized.
Birth defects and paternal occupational exposure. Hypotheses tested in a record linkage based dataset
Authors: IRGENS ÅGOT , KRÜGER KIRSTI , SKORVE ANNE HELENE , IRGENS LORENTZ M. 
Published: March 2003

Main question. To test previously established hypotheses on associations of birth defects with paternal occupation on the basis of a Norwegian registry material.Methods. The study comprised all births in Norway 1970 ‐1993 for which linkage with population censuses 1970, ‐80 and ‐90 on parents' job title could be obtained – about 1 million births (75% all births). The reference population was offspring of the group that did not belong to the actual occupation.Results. Vehicle mechanics had an association with hypospadias –OR 5.19 ( CI 1.31–14.24), painters had a non‐significant association with spina bifida – OR 2.03 (CI 0.99–3.75) and printers with club foot – OR 1.61 (CI 0.89–2.90). Associations observed previously in offspring of fathers in large occupational groups such as teachers, drivers, electricity related occupations, sales related occupations and agricultural workers were not confirmed in this dataset.Conclusions. The study gave further evidence of cause effect relationships in the confirmed positive associations, though without any clarification of possible mechanisms involved. Possible false negative findings might be caused by low statistical power due to small occupational groups or non‐differential misclassification of exposure.