bluuebunny/crossref_metadata_2025_split huggingface dataset:
A cluster analysis of road traffic‐related childhood knee injuries
Authors: Iakovakis I. , Dessypris N. , Dalamaga M. , Petridou E. 
Published: June 2003

AbstractBackground  Knee injuries represent an important category of road traffic injuries among children, and they are heterogeneous in their aetiology. The aims of this study were to estimate the incidence of road traffic childhood knee injuries in Greece by age and gender, point out their time, place and person co‐ordinates and identify clusters with distinct characteristics with a view to potential preventive interventions.Methods  During a 3‐year period, 305 children with knee injuries resulting from a road traffic accident were identified among the 66 870 children with injuries recorded in the Emergency Department Injury Surveillance System (EDISS) of Greece. Using previously derived sampling ratios and national data on childhood population, incidence data by age and gender were estimated. Hierarchical analysis was undertaken for cluster identification.Results  The incidence of road traffic knee injuries was 97.5 per 100 000 children–years. The incidence increased with age and was higher among boys than among girls. Most childhood knee injuries (50.2%) occur among pedestrians, and the majority (90.9%) of the children or their guardians admitted responsibility in crossing the road. Of the 31 children injured as car passengers, the vast majority (87.1%) were unrestrained, and a large fraction (38.7%) were front seat passengers. Two clusters were identified: the first consisted of younger children who resided mostly in the Athens area and suffered less serious knee injuries as pedestrians or car passengers during the colder months; the second consisted of older children, frequently tourists, who suffered more serious injuries as cyclists while vacationing.Conclusions  Many of the children who suffered road traffic knee injuries as pedestrians admitted responsibility in road crossing, whereas a large proportion of children who were injured as car passengers were injured while improperly seated in the front and without seatbelt protection. Older children, frequently tourists, were at high risk of knee injuries while using motorcycles and bicycles.
Why do parents decide against immunization? The effect of health beliefs and health professionals
Authors: Smailbegovic M. S. , Laing G. J. , Bedford H. 
Published: June 2003

AbstractObjectives  To explore the knowledge, attitudes and concerns with respect to immunization and vaccine‐preventable infections in parents whose children have not completed the recommended course of immunization.Setting  Parents of children resident in the London Borough of Hackney.Methods   Children born between 1 January 1999 and 15 February 1999 were identified from the child health database, and cases were defined as those who had defaulted for one or more primary immunization by 18 months of age. After validation of immunization status from health records, questionnaires were sent to parents. Ten respondents from this sample were interviewed.Results   Questionnaires were sent to 129 parents of children identified as not completing the recommended immunization course. Nine questionnaires were returned ‘address unknown’, and 76 parents returned the completed questionnaire. The response rate from known residents was 76/110 (69%). Eight parents stated that their child had been immunized, leaving 68 questionnaires available for further analysis. Measles, mumps, rubella (MMR) and meningococcal C were most frequently omitted, usually because of concerns about vaccine safety. Twenty‐three out of 68 respondents perceived that having their child immunized with a particular vaccine was more risky than non‐immunization, particularly for MMR and meningococcal C vaccines. Those who agreed to be interviewed were notably concerned about the MMR vaccine, but not immunization in general. They perceived the information provided by health professionals to be poor.Conclusions   The decision‐making process around childhood immunization is complex. Parents require information that is up to date, tailored to their individual needs and provided by health professionals who are well informed.
Recovery of T‐cell subsets after antiretroviral therapy in HIV‐infected children
Authors: Resino S. , Bellón J. Ma. , Gurbindo D. , León J. A. , Muñoz‐Fernández Ma. Á. 
Published: June 2003

AbstractBackground Variation of percentageCD4+ T cells may accurately reflects the kinetics of a comprehensive immune recovery independently of the antiretroviral (ART) regimen. To test this we have investigated the relationship among peripheral blood T‐cell subsets with the variation of percentageCD4+ T cells during follow up in 49 HIV‐infected children.Methods Children were divided into two groups according to the sign of slope percentageCD4+ T cell during follow up: Ps‐group (positive slope) and Ns‐group (negative percentageCD4 slope) indicative of immunological recovery or not, respectively. CD4+ and CD8+ T‐cell subset percentages were examined by three‐colour flow cytometry.Results We found higher memory CD4+ and CD8+ T‐cell percentages in the Ns‐group than in the Ps‐group, and inversely, higher naive CD4+ and CD8+ T cells in the Ps‐group than in the Ns‐group. CD4+ and CD8+ subsets in the Ps‐group expressed higher levels of CD38+ and lower levels of HLA‐DR+ compared with the Ns‐group. We found a very strong positive correlation among the slope of percentageCD4+, CD4+ CD38+, whereas a negative correlation among the slope of percentageCD4+, the CD8+ CD28+ CD57+ and CD8+ CD57+ T‐cell subsets.Conclusion Recovery of the CD4+ T‐cell percentage induced by ART reflects a reduction in the chronic immune activation and a measurable reconstitution of the immune system and depends on naive CD4+ T cells.
Fibrinogen, inflammation and concentric left ventricular hypertrophy in chronic renal failure
Authors: Zoccali C. , Benedetto F. A. , Mallamaci F. , Tripepi G. , Cutrupi S. , Parlongo S. , Malatino L. S. , Bonanno G. , Rapisarda F. , Fatuzzo P. , Seminara G. , Nicocia G. , Buemi M. 
Published: June 2003

AbstractBackground We investigated the relationship between fibrinogen and echocardiographic measurements of left ventricular (LV) geometry and LV function in a group of 192 patients with end stage renal disease (ESRD).Results Patients in the third fibrinogen tertile had higher mean wall thickness (MWT), relative wall thickness (RWT) and left ventricular mass index (LVMI) and lower LV end diastolic diameter and LV ejection fraction than those in the other tertiles. On multivariate analysis fibrinogen resulted to be an independent correlate of MWT (P = 0·001) and RWT (P = 0·0001) and the first factor in rank explaining the variance in LV ejection fraction (P = 0·0001). Left ventricular concentric hypertrophy was more prevalent (P = 0·001) in patients in the third fibrinogen tertile (n = 35, 54%) than in those in the second (n = 24, 37%) and first (n = 13, 21%) tertiles. In a multiple logistic regression model patients in the third tertile of fibrinogen had a risk for left ventricular concentric hypertrophy that was 3·56 (95%CI: 1·56–8·14) fold higher than in those in the first tertile (P = 0·003).Conclusions Elevated fibrinogen is independently associated with LV concentric hypertrophy and systolic dysfunction in ESRD patients. These relationships may contribute to the negative prognostic impact of elevated fibrinogen levels in ESRD.
Impaired cardiovagal and vasomotor responses to baroreceptor stimulation in type II diabetes mellitus
Authors: Sanya E. O. , Brown C. M. , Dütsch M. , Zikeli U. , Neundörfer B. , Hilz M. J. 
Published: June 2003

AbstractBackground In diabetic patients, impairment of the cardiovagal limb of the baroreflex has been well established. However, the role of sympathetic mediated baroreflex vasomotor control of the blood vessels is not well defined. We therefore assessed the vasomotor responses to sinusoidal baroreceptor stimulation in diabetic patients.Materials and methods We studied 14 type II diabetic patients (age; 57 ± 7 years) and 18 healthy controls (age; 59 ± 11 years). Oscillatory neck suction was applied at 0·1 Hz to assess the sympathetic modulation of the heart and blood vessels, and at 0·2 Hz to assess the effect of parasympathetic stimulation on the heart. Breathing was paced at 0·25 Hz. Spectral analysis was used to evaluate the oscillatory responses of RR‐interval and blood pressure.Results The diabetic patients showed a significantly lower RR‐interval response (P < 0·05) to the 0·1 Hz neck suction (2·52 ± 0·50–3·62 ± 0·54 ln ms2) than the controls (4·23 ± 0·31–6·74 ± 0·36 ln ms2). The increase in power of 0·1 Hz systolic blood pressure oscillations during 0·1 Hz suction was also significantly smaller (P < 0·05) in the diabetics (1·17 ± 0·44–1·69 ± 0·44 mmHg2) than in the controls (1·60 ± 0·29 mmHg2−5·87 ± 1·25 mmHg2). The magnitude of the peak of the 0·2 Hz oscillation in the RR‐interval in response to 0·2 Hz neck stimulation was significantly greater (P < 0·05) in the controls (3·42 ± 0·46 ln ms2) than in the diabetics (1·58 ± 0·44 ln ms2).Conclusion In addition to cardiovagal dysfunction, baroreflex‐mediated sympathetic modulation of the blood vessels is impaired in type II diabetic patients.
Decreased cortisol production in male type 1 diabetic patients
Authors: Kerstens M. N. , Luik P. T. , Van Der Kleij F. G. H. , Boonstra A. H. , Breukelman H. , Sluiter W. J. , Navis G. J. , Dullaart R. P. F. 
Published: June 2003

AbstractBackground It is unclear whether cortisol production and the 11βHSD‐mediated cortisol to cortisone interconversion are different between type 1 diabetic patients and healthy subjects.Materials and methods Fourteen male, nonobese, normotensive type 1 diabetic patients without severe complications (HbA1c < 8·5%) were studied twice during a daily sodium intake of 50 and 200 mmol, and were then compared with 14 individually matched healthy subjects. Cortisol production was assessed by the sum of urinary cortisol metabolite excretion. Urinary ratios of (tetrahydrocortisol + allo‐tetrahydrocortisol)/tetrahydro‐cortisone [(THF + allo‐THF)/THE] and of free cortisol/free cortisone [UFF/UFE] were determined as parameters of 11βHSD activity.Results Sum of urinary cortisol metabolite excretion during low‐ and high‐salt diet was 7·4 ± 2·5 vs. 7·7 ± 2·3 nmol min−1 m−2 (NS) in diabetic patients and 9·7 ± 2·1 vs. 11·2 ± 4·1 nmol min−1 m−2 (NS) in healthy subjects, respectively (P < 0·05 vs. healthy subjects at both diets). The allo‐THF excretion and allo‐THF/THF ratios were lower in the diabetic than in the healthy males during both diets (P < 0·05). Urinary (THF + alloTHF)/THE and UFF/UFE were similar in both groups and remained unchanged after salt loading.Conclusions The sum of urinary cortisol metabolite excretion as a measure of cortisol production is lower in nonobese, normotensive type 1 diabetic males with adequate glycaemic control and without severe complications, irrespective of sodium intake. We suggest that this is at least in part as result of diminished 5α reductase activity, resulting in a decreased cortisol metabolic clearance. In type 1 diabetic and in healthy males, the 11βHSD setpoint is not affected by physiological variations in sodium intake.
Numbers of colony‐forming progenitors in patients with systemic mastocytosis: potential diagnostic implications and comparison with myeloproliferative disorders
Authors: Jordan J.‐H. , Jäger E. , Sperr W. R. , Schwarzinger I. , Födinger M. , Fritsche‐Polanz R. , Öhler L. , Geissler K. , Valent P. 
Published: June 2003

AbstractBackground An increase in colony‐forming progenitor cells (CFU) is typically seen in myeloproliferative disorders (MPD). Systemic mastocytosis (SM) is a haemopoietic neoplasm involving myeloid progenitors similar to MPD. In the present study, we measured the levels of peripheral blood (pb) and bone marrow (bm) CFU in patients with different categories of SM, and compared them with those obtained in MPD patients and healthy controls.Materials and methods Numbers of CFU (CFU‐GM, BFU‐E, CFU‐GEMM) were measured in a colony assay in 25 patients with SM [indolent SM (ISM), n = 15; smouldering SM (SSM), n = 3; SM with an associated haematologic clonal non‐mast cell lineage disease (SM‐AHNMD), n = 5; aggressive SM (ASM), n = 1; mast cell leukaemia (MCL), n = 1] and 37 with MPD [chronic myeloid leukaemia (CML), n = 10; polycythemia vera (PV), n = 8; essential thrombocytosis (ET), n = 9; idiopathic myelofibrosis (IMF), n = 10].Results In the patients with MPD, elevated numbers of pb CFU were detected in all groups when compared with healthy controls (P < 0·05). In most of the patients with ISM, circulating CFU levels (CFU‐GM, BFU‐E, and CFU‐GEMM) were within the normal range. In SSM, pb CFU‐GM levels were normal in two patients, and elevated in a third patient. In the ‘SM‐AHNMD‐group’, CFU levels were found to reflect the nature of the AHNMD: in SM with concomitant acute myeloid leukaemia (SM‐AML, n = 2), the levels of CFU were low or undetectable, whereas in SM with chronic myelomonocytic leukaemia (SM‐CMML, n = 2), elevated numbers of pb CFU‐GM were found.Conclusion The numbers of CFU are normal in patients with ISM, but elevated in some patients with SSM and SM‐CMML. An elevated CFU level in SM should raise the suspicion of an associated MPD (CMML) or smouldering SM, a novel SM‐subtype that shares several features with MPD and sometimes progresses to an overt SM‐MPD.
Measurement of the soluble angiopoietin receptor tie‐2 in patients with coronary artery disease: development and application of an immunoassay
Authors: Chung N. A. Y. , Makin A. J. , Lip G. Y. H. 
Published: June 2003

AbstractBackground The angiopoietin family has emerged as a group of crucial growth factors to normal angiogenesis. They are essential to the development of the mature vessel wall and interact with the endothelium via endothelial cell‐specific tyrosine kinase receptors, tie‐1 and tie‐2. The role of the tie‐2 receptor has been extensively examined in neovascularization associated with malignancy, but little is known about the role it may play in atherosclerosis, a condition whose pathophysiology also involves angiogenesis. Soluble tie‐2 has been detected in the plasma of healthy controls, but this has yet to be applied to patients in the clinical setting.Materials and methods We developed an ELISA to detect plasma tie‐2 levels and applied these to a clinical setting. The intra‐ and interassay coefficients of variation for the assay were 4·7% and 9·6%, respectively. We then measured levels of tie‐2, vascular endothelial growth factor (VEGF), another factor associated with angiogenesis, and the soluble VEGF receptor Flt‐1 (sFlt‐1) in 75 patients with coronary artery disease [25 with acute myocardial infarction (AMI), 25 with acute coronary syndromes (ACS) and 25 with stable angina] and 25 healthy controls.Results Median [IQR, interquartile range] levels of tie‐2 were significantly higher in the coronary artery disease patients (AMI 12 [10–17] ng mL−1, ACS 10 [9–14] ng mL−1, stable angina 9 [3–11] ng mL−1) when compared with the controls (7·5 [7–9] ng mL−1P = 0·004). As expected, levels of VEGF and sFlt were significantly different from those in the healthy controls (P = 0·011 and P < 0·001, respectively). Significant correlations were found between levels of tie‐2 and VEGF (Spearman r = 0·59, P < 0·001), tie‐2 and sFlt‐1 (r = 0·45, P < 0·001) and VEGF and sFlt‐1 (r = 0·56, P < 0·001) in the whole study group.Conclusion We suggest that tie‐2 may be potentially used as a marker of angiogenesis in atherosclerosis and may help elucidate the role of the angiopoietin/tie‐2 system in atherogenesis.
Effects of rosiglitazone and linoleic acid on human preadipocyte differentiation
Authors: Hutley L. J. , Newell F. M. , Joyner J. M. , Suchting S. J. , Herington A. C. , Cameron D. P. , Prins J. B. 
Published: June 2003

AbstractBackground Peroxisome proliferator activated receptor gamma (PPARγ) is a ligand‐activated transcription factor known to be central to both adipose tissue development and insulin action. Growth of adipose tissue requires differentiation of preadipocytes with acquisition of specific cellular functions including insulin sensitivity, leptin secretion and the capacity to store triglyceride. Dietary fatty acids and members of the thiazolidinedione class of compounds have been reported to influence adipogenesis at the transcriptional level. Here, we compare the effects of a dietary fatty acid, linoleic acid, and a thiazolidinedione, rosiglitazone, on biochemical and functional aspects of human preadipocyte differentiation in vitro.Materials and methods Human omental and subcutaneous preadipocytes were subcultured 2–3 times and subsequently differentiated for 21 days in the presence of either linoleic acid or rosiglitazone. Differentiation was assessed using a number of biochemical and functional parameters.Results Omental and subcutaneous preadipocytes differentiated in the presence of linoleic acid showed marked cytoplasmic triacylglycerol accumulation however, no biochemical markers of differentiation (LPL expression, G3PDH gene expression and enzyme activity and leptin expression or secretion) were detected. In contrast, treatment of these cells with rosiglitazone induced full biochemical differentiation as judged by all markers assessed, despite comparatively little lipid accumulation. The rosiglitazone effects were subcutaneous depot‐specific. Cells treated with linoleic acid showed decreased glucose uptake cf rosiglitazone‐treated cells. A luciferase reporter assay demonstrated that rosiglitazone potently activates h‐peroxisome proliferator activated receptor gamma while linoleic acid had no effect.Conclusions These studies demonstrate that (a) human preadipocytes have the potential to accumulate triacylglycerol irrespective of their stage of biochemical differentiation; (b) while omental preadipocytes are refractory to biochemical differentiation in vitro, they are able to accumulate triacylglycerol; and (c) rosiglitazone and linoleic acid may exert their effects via different biochemical pathways.
Individuals at increased coronary heart disease risk are characterized by an impaired microvascular function in skin
Authors: IJzerman R. G. , De Jongh R. T. , Beijk M. A. M. , Van Weissenbruch M. M. , Delemarre‐van de Waal H. A. , Serné E. H. , Stehouwer C. D. A. 
Published: June 2003

AbstractBackground To investigate whether microvascular function in skin is a valid model to study the relationships between cardiovascular risk factors and microvascular function, we investigated skin microvascular function in individuals with increased coronary heart disease (CHD) risk.Materials and methods Forty‐six healthy White individuals aged 30–70 years were studied. Coronary heart disease risk was assessed with the use of the CHD risk score according to the Framingham Heart Study, which is based on the risk factors age, blood pressure, cigarette smoking, total cholesterol, HDL cholesterol and diabetes. Endothelium‐dependent and ‐independent vasodilation in skin were evaluated with laser Doppler after iontophoresis of acetylcholine and sodium nitroprusside. Videomicroscopy was used to measure recruitment of skin capillaries after arterial occlusion.Results Coronary heart disease risk score (i.e. the 10‐year probability of CHD) varied from 1–37%. Microvascular function decreased with increasing quartiles of CHD risk (for acetylcholine‐mediated vasodilation: 687, 585, 420 and 326%, P = 0·002; for nitroprusside‐mediated vasodilation: 776, 582, 513 and 366%, P = 0·02; for capillary recruitment: 49·9, 44·6, 27·2 and 26·7%, P = 0·001). These trends were similar in men and women (P for interaction > 0·2) and independent of body mass index.Conclusions Increased CHD risk is associated with an impaired endothelium‐dependent vasodilatation and capillary recruitment in skin, suggesting that microvascular function in skin is a valid model to study the relationships between cardiovascular risk factors and microvascular function.
Low mast cell density in the human duodenal mucosa from chronic inflammatory duodenal bowel disorders is associated with defective villous architecture
Authors: Crivellato E. , Finato N. , Isola M. , Ribatti D. , Beltrami C. A. 
Published: June 2003

AbstractBackground Mast cells (MC) have recently been implicated in the processes of tissue homeostasis, remodeling and repair.Design In this study, the total and tryptase‐reactive mast cell populations were quantified in the duodenal mucosa of 27 subjects suffering from chronic inflammatory bowel disorders. Mast cell density was both related to the general villous architecture (normal or defective) and to the microvascular density in the duodenal mucosa.Results Total mast cell and tryptase‐positive mast cell subpopulation densities were found to be significantly reduced in the samples with defective villous architecture in comparison with those exhibiting a normal villous profile. In these last samples, a relevant proportion of mucosal mast cells exhibited ultrastructural features of secretory activity, in particular piecemeal degranulation. Finally, no correlation was established between microvascular density and tryptase activity, as it has been previously demonstrated in other pathological conditions.Conclusions Overall, these findings indicate a significant correlation between mast cell density and the duodenal mucosal architecture.
Hyperhomocysteinaemia is not associated with increased levels of asymmetric dimethylarginine in patients with ischaemic heart disease
Authors: Jonasson T. F. , Hedner T. , Hultberg B. , Öhlin H. 
Published: June 2003

AbstractBackground Elevated plasma total homocysteine appears to be related to endothelial dysfunction and impaired nitric oxide production. We aimed to investigate [1] whether elevated levels of plasma total homocysteine are associated with high plasma levels of asymmetric dimethylarginine, an endogenous inhibitor of nitric oxide synthase, and [2] whether reduction of plasma total homocysteine levels by folate and vitamin B supplementation lowers plasma concentration of asymmetric dimethylarginine.Materials and methods Sixty patients with ischaemic heart disease and with plasma total homocysteine levels of 15·0 µmol L−1 were randomized to open therapy with folic acid, pyridoxine and cyancobalamin for 3 months (n = 30) or to no treatment (n = 30). Samples were also obtained from 34 patients with plasma total homocysteine levels of 8·0 µmol L−1 on admission.Results Plasma asymmetric dimethylarginine concentrations in patients with elevated total homocysteine levels were not significantly higher (0·68 ± 0·19 µmol L−1) than in patients with low total homocysteine levels (0·61 ± 0·10 µmol L−1; P = 0·08). Plasma asymmetric dimethylarginine level in the vitamin supplemented group was 0·65 ± 0·12 µmol L−1 before, and 0·64 ± 0·12 µmol L−1 after 3 months of vitamin supplementation (NS). Plasma asymmetric dimethylarginine levels were correlated with serum cystatin C levels (P < 0·001).Conclusion A nonsignificant trend to increased plasma levels of asymmetric dimethylarginine in patients with high plasma total homocysteine levels may be explained by concomitant subtle renal dysfunction. Substantial reduction of plasma total homocysteine did not affect the level of plasma asymmetric dimethylarginine.