bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nine months postpartum weight retention predictors for Brazilian women
Authors: Kac Gilberto , Benicio Maria HDA , Velásquez-Meléndez Gustavo , Valente Joaquim G 
Published: July 2004

AbstractObjective:To identify factors potentially associated with weight retention measured 9 months after childbirth.Design:Prospective study with four follow-up waves in time (0.5, 2, 6 and 9 months postpartum).Setting:Rio de Janeiro, Brazil.Subjects and methods:Two hundred and sixty-six Brazilian women of childbearing age. Analysis was based on hierarchical logistic regression. The dependent variable was weight retention and was defined as the difference between weight at 9 months postpartum and pre-pregnancy weight, with a dichotomised cut-off at 7.5 kg. Covariates included demographic and socio-economic data, obstetric history, anthropometric data, and data on the infant. These data were grouped in blocks and ordered according to their influence on the dependent variable.Results:Of the women studied, 19.2% presented weight retention values ≥7.5 kg. According to the logistic regression analysis, the following variables remained associated with weight retention ≥7.5 kg: total family income, difficulty or inability to read a letter, age category ≥30 years, age at first childbirth <23 years, gestational weight gain ≥12 kg, body fat at baseline ≥30% and infant birth weight <3500 g. Infant hospitalisation was only marginally significant.Conclusions:Determinant factors identified by the analysis highlight the need for nutritional intervention policies during pregnancy and in the first months postpartum as a way of minimising obesity and the diseases resulting from it.
Waist circumference as a determinant of hypertension and diabetes in Brazilian women: a population-based study
Authors: Olinto MTA , Nacul LC , Gigante DP , Costa JSD , Menezes AMB , Macedo S 
Published: July 2004

AbstractObjective:To evaluate the role of central adiposity, as evaluated by the measurement of waist circumference (WC), as an independent risk factor for hypertension and type 2 diabetes mellitus in the setting of a developing country.Design:Population-based, cross-sectional study.Setting:A medium-sized town in southern Brazil.Participants:One thousand and ninety-five non-pregnant women, 20 to 69 years old, recruited by cluster random sampling between 1999 and 2000. Their mean WC was 85.3 cm (standard deviation 13.9 cm) and 23.3% (n = 255) were obese (body mass index >30 kg m−2). The prevalence of hypertension and diabetes was 25.6% (n = 280) and 6.2% (n = 68), respectively.Results:The risks of hypertension and diabetes were directly related to WC measurement. Women with WC > 80 cm had increased risk of hypertension (odds ratio (OR) = 6.2, P < 0.001). The association remained significant (OR = 1.04 per cm increase in WC, P = 0.02) after adjusting for confounders. The effect of WC on diabetes was modified by age. The effect was stronger in women younger than 40 years old (OR = 12.7, P = 0.016) than in those over 40 years old (OR = 2.8, P = 0.013). In the multivariate analysis, the odds ratio was 5.7 (P = 0.12) in those under 40 years old and 2.8 (P = 0.008) in older women.Conclusions:Waist circumference is an independent determinant for hypertension and diabetes in women in this population. The stronger association between WC and diabetes in younger women suggests that the validity of this indicator to assess abdominal adiposity is age-specific. Further studies should validate the usefulness of WC measurement in different age groups.
Stakeholding: Confusion or Utopia? Mapping the Conceptual Terrain
Authors: Stoney Christopher , Winstanley Diana 
Published: July 2004

The paper has three main objectives. The first aim is to examine and clarify the burgeoning stakeholder literature that currently seeks to inform management practice, corporate governance and public policy with particular emphasis on the UK. We do this by continuing the process of clarification started by Donaldson and Preston (1995), focusing mainly on the political and practitioner literature generated within the UK. We begin this task by setting out a critique of stakeholding and develop this by using four key themes of enquiry. First, we examine stakeholding’s conceptual confusion; second, we outline and develop criticism of its underlying pluralist assumptions; third, we consider the problems of implementation; and finally, we assess some of the key arguments concerning its potential impact on business performance and competitiveness.The second aim is to develop and examine the central criticisms of stakeholding from both the neo‐liberal and Marxist/radical perspectives. By so doing we identify the key theoretical and practical issues which stakeholder proponents must address if they are to convince sceptics of the model’s validity.The third aim is to develop a conceptual framework capable of illustrating the different stakeholder perspectives and assumptions on which they are based. This consists of five continuums: the first locates authors on a left–right political continuum; the second distinguishes between those authors who use stakeholding primarily for analysis and those who use it to formulate and prescribe specific courses of action; the third differentiates between intrinsic (good in itself) and instrumental (means to an end) motives; the fourth identifies the various levels of proposed intervention; and the fifth illustrates the different degrees of enforcement advocated.We believe that this framework provides a clear illustration of our arguments and serves as a useful instrument for clarifying the stakeholder concept. In addition, it is used to position or map the work of key authors within the stakeholder debate and we believe it may provide a more coherent basis for future research and debate.
Todd, Faraday, and the Electrical Basis of Epilepsy
Authors: Reynolds Edward H. 
Published: July 2004

Summary:  Purpose: To consider the origins of our understanding of the electrical basis of epilepsy in the light of the Lumleian lectures to the Royal College of Physicians in London for 1849, “On the pathology and treatment of convulsive diseases,” by Robert Bentley Todd (1809–1860). Methods: I have reviewed Todd's neglected Lumleian lectures and his observations and concepts of the electrical basis of epilepsy in relation to the influence of Michael Faraday (1791–1867), his contemporary in London, and in relation to later nineteenth century writings on the subject by Jackson, Ferrier, and Hitzig, all of whom overlooked Todd's lectures. Results: Todd was a clinical scientist as well as Professor of Physiology and Morbid Anatomy, with a special interest in the nervous system, at King's College, where he came into contact with Michael Faraday, the greatest electrical scientist of all time, at the nearby Royal Institution. On the basis of his own clinical and experimental studies and his cutting‐edge knowledge of neuroanatomy, neurophysiology, neuropathology, and electrical science, Todd brilliantly developed his concepts of the electrical basis of brain activity and of epilepsy in particular. With his microscope, he perceived each nerve vesicle and its related fibres (neurone in later terminology) as distinct entities for the generation of nervous polarity (force) and its transmission in the white nerve fibres throughout the nervous system by unknown molecular mechanisms. In epilepsy, an increase in electrical tension, especially in the grey matter of the hemispheres, led to periodic, sudden explosive discharges, based on Faraday's concept of disruptive discharges. Conclusions: Todd was the United Kingdom's first outstanding neurologist and neuroscientist before these disciplines existed. Influenced by Faraday, he proposed and confirmed the electrical basis of nervous discharges in epilepsy more than 20 years ahead of Jackson, Ferrier, and Hitzig, who did not refer to his priority, although Ferrier also worked at King's College, and Jackson also gave his own famous Lumleian lectures on the same subject in 1890. Todd deserves the credit for laying the foundations of our modern understanding of epilepsy.
Dialyzability of the Antiepileptic Drug Zonisamide in Patients Undergoing Hemodialysis
Authors: Ijiri Yoshio , Inoue Toru , Fukuda Fumio , Suzuki Kaoru , Kobayashi Toyohide , Shibahara Nobuhisa , Takenaka Hiroshi , Tanaka Kazuhiko 
Published: July 2004

Summary:  Purpose: The influence of hemodialysis on plasma zonisamide (ZNS) concentration has not been clarified. In this study, the dialyzability of ZNS during hemodialysis was investigated in four ZNS‐treated women with systemic lupus erythematosus complicated by seizures. Methods: The total and unbound plasma concentrations of ZNS were measured before and after hemodialysis. The concentration of ZNS in the spent dialysate also was determined. Results: The reduction in plasma ZNS concentration after a 4.5‐h hemodialysis was 52.0 ± 7.6%, and the dialyzer (BLF‐16GW) clearance of ZNS was 55.1 ± 7.0 ml/min. Dosage was gradually increased up to 200 to 500 mg/day, and the seizures were controlled satisfactorily. Conclusions: The plasma concentration of ZNS was reduced by approximately 50% during one session of dialysis. For patients undergoing daytime hemodialysis sessions every 2 or 3 days, the usual dosage of ZNS (4–8 mg/kg/day) may be prescribed once a day in the evening. If seizures occur after hemodialysis, a supplemental daily dose may be prescribed in the morning.
Distribution of Cortical Interneurons in Grey Matter Heterotopia in Patients with Epilepsy
Authors: Thom Maria , Martinian Lillian , Parnavelas John G. , Sisodiya Sanjay M. 
Published: July 2004

Summary:  Purpose: Grey matter heterotopia are well‐defined malformations of the cortex often associated with severe epilepsy. Defects have been identified in genes, including DCX and FLN1, that influence radial migration of postmitotic cells from the ventricular zone to the cortical plate. A proportion of cortical γ‐aminobutyric acid (GABA)‐containing interneurons may arise from the ganglionic eminence of the ventral telencephalon. We aimed to identify the subtypes and localisation of interneurons within grey matter heterotopia relative to cortex. Methods: By using quantitative immunohistochemistry, we studied the density and distribution of interneurons within six cases of grey matter heterotopia in postmortem tissue from patients with epilepsy. Results: In many cases, a suggestion of focal rudimentary laminar arrangement and small reelin‐positive cells was identified within the heterotopia. Immunohistochemistry for glutamic acid decarboxylase65/57, parvalbumin, calbindin, and calretinin showed inhibitory neurons of all subtypes represented within the heterotopia, and of normal morphology. The mean densities of interneurons were overall similar to those of the overlying cortex, but the interneurons showed less organisation and were more randomly orientated compared with cortex. Conclusions: Interneurons within heterotopia probably arise from the ventricular zone, but their abnormal local organization may influence the epileptogenicity of these lesions.
Advances in the molecular and serological diagnosis of invasive fungal infection in haemato‐oncology patients
Authors: McLintock Lorna A. , Jones Brian L. 
Published: July 2004

SummaryCurrent laboratory diagnostic methods for invasive fungal infection (IFI) in haemato‐oncology patients are insensitive, resulting in late diagnosis and contributing to high mortality. In recent years, progress has been made in the development and evaluation of sensitive sero‐diagnostic assays, including detection of genomic DNA sequences and fungal antigens, which aid in a rapid, early diagnosis of IFI. The sensitivity and specificity of the assays vary considerably between studies, highlighting the need to correlate serological results with conventional laboratory tests and clinical or radiological findings. As part of management protocols, these assays may help to confirm the diagnosis of suspected IFI; however, the impact on mortality from IFI may be greatest when they are used to screen high‐risk patients. Persistently positive screening results could direct early aggressive antifungal therapy, guided further by radiological and microbiological findings combined with regular clinical review, while the excellent negative predictive value may allow treatment to be withheld in patients with antibiotic resistant neutropenic fever but no other signs of IFI. However, this pre‐emptive approach requires evaluation in prospective randomized trials.
Complex chromosomal abnormalities in utero, 5 years before leukaemia*
Authors: Broadfield Zoë J. , Hain Richard D. W. , Harrison Christine J. , Reza Jalali G. , McKinley Mark , Michalová Kyra , Robinson Hazel M. , Zemanová Zuzana , Martineau Mary 
Published: July 2004

SummaryPrenatal acquisition of leukaemia‐associated gene rearrangements is a well‐established phenomenon. This is the first report of a complex cytogenetic clone, in association with an ETV6/AML1 fusion, developing in utero. Identical twin girls, aged 4 years, developed ETV6/AML1‐positive acute lymphoblastic leukaemia (ALL) within 3 months of one another. Both demonstrated an identical four way, variant t(12;21). There was gain of an AML1 signal in twin 1 and loss of an ETV6 one in twin 2 at interphase. This unique case study demonstrates that ETV6/AML1 fusion and the associated complex chromosomal rearrangements occurred in utero. Clonal expansion of the abnormal cell in one twin was followed by metastasis to the other. There was a prolonged preleukaemic phase, which lasted well into childhood. The short time between the two diagnoses of ALL suggests a common precipitating event. The significance of the different secondary markers remains unclear.
Serum free light chains for monitoring multiple myeloma
Authors: Mead G. P. , Carr‐Smith H. D. , Drayson M. T. , Morgan G. J. , Child J. A. , Bradwell A. R. 
Published: July 2004

SummaryMonoclonal immunoglobulin free light chains (FLC) are found in the serum and urine of patients with a number of B‐cell proliferative disorders, including multiple myeloma. Automated immunoassays, which can measure FLC in serum, are useful for the diagnosis and monitoring of light chain (AL) amyloidosis, Bence Jones myeloma and non‐secretory myeloma patients. We report the results of a study investigating the utility of serum FLC measurements in myeloma patients producing monoclonal intact immunoglobulin proteins. FLC concentrations were measured in presentation sera from 493 multiple myeloma patients with monoclonal, intact immunoglobulin proteins. Serial samples were assayed from 17 of these patients and the FLC measurements were compared with other disease markers. Serum FLC concentrations were abnormal in 96% of patients at presentation. FLC concentrations fell more rapidly in response to treatment than intact immunoglobulin G (IgG) and showed greater concordance with serum β2 microglobulin concentrations and bone marrow plasma cell assessments. It was concluded that serum FLC assays could be used to follow the disease course in nearly all multiple myeloma patients. In addition, because of their short serum half‐life, changes in serum FLC concentrations provide a rapid indication of the response to treatment.
Bone marrow histological patterns can predict survival of patients with grade 1 or 2 follicular lymphoma: a study from the Groupe d‘Etude des Lymphomes Folliculaires
Authors: Canioni Danielle , Brice Pauline , Lepage Eric , Chababi Myrna , Meignin Véronique , Salles Bruno , Xerri Luc , Péaud Pierre‐Yves , Rousselot Philippe , Peuchmaur Michel , Solal‐Céligny Philippe , Brousse Nicole ,   The Groupe d'Etude des Lymphomes Folliculaires
Published: July 2004

SummaryThe influence of bone marrow biopsy (BMB) histology on prognosis and management of follicular lymphomas (FL) remains controversial. A total of 390 patients with grade 1 or 2 FL were prospectively included in the multicentric Groupe d'Etude des Lymphomes Folliculaires trial and their BMB reviewed in order (i) to quantify the ratio of lymphomatous foci (LFo) area to that of BMB size (LFo/BMB), (ii) to determine the BMB patterns for a practical grading of marrow infiltration, (iii) to assess the intra‐ and inter‐observer reproducibility of this grading and (iv) to analyse this grading on event‐free (EFS) and overall survival (OS), using univariate and multivariate analyses. A total of 267 patients (68%) had BMB involvement, with inter‐ and intra‐observer reproducibility for classifying the patterns of involvement of 91 and 96%, respectively. Uni‐ and multivariate analyses demonstrated the adverse influence of (i) a ratio of LFo/BMB ≥0·1, i.e. three or four nodules/medullary space or ≥1 nodule + foci of diffuse involvement on EFS (P = 0·03) and (ii) two different histological patterns in the same BMB on EFS (P = 0·004) and OS (P = 0·001). This latter finding was only significant in patients with a high tumour burden and remained significant in multivariate analysis. These results indicate that BMB histology can predict survival of FL patients with a high tumour burden, and may help in defining their treatment.
The recurrent translocation t(14;20)(q32;q12) in multiple myeloma results in aberrant expression of MAFB: a molecular and genetic analysis of the chromosomal breakpoint
Authors: Boersma‐Vreugdenhil Gienke R. , Kuipers Jeroen , Van Stralen Esther , Peeters Ton , Michaux Lucienne , Hagemeijer Anne , Pearson Peter L. , Clevers Hans C. , Bast Bert J. E. G. 
Published: July 2004

SummaryChromosomal translocations of the immunoglobulin heavy chain (IgH) gene region at 14q32 are regularly involved in B lymphoid malignancies; they may initiate transformation either by deregulation of existing (proto) oncogenes or creation of new hybrid genes with transforming properties. Previously, we reported a reciprocal novel translocation, t(14;20)(q32;q12), found in the myeloma cell line UM3. In this cell line, the t(14;20) is the only translocation involving the IgH locus. Using double colour immunofluorescence in situ hybridization, the t(14;20) was also found in the diagnostic bone marrow sample, excluding a possible in vitro artefact. We also have found this recurrent t(14;20) in four other cell lines and in additional patient material. We cloned the regions containing the breakpoints in the der(14) and der(20) chromosomes from UM3, and analysed ectopic mRNA expression of genes in the breakpoint regions of both derivative chromosomes. Ectopic gene expression was observed for the transcription factor MAFB in der(14). The breakpoint scatter in the five cell lines with a t(14;20) – all expressing MAFB– is comprised within a region of 0·8 Mb. Provisional data indicate that this t(14;20) is associated with an adverse prognosis. Aberrant expression of MAFB may be involved in the oncogenic transformation of myeloma cells that harbour the t(14;20).
Prospective evaluation of procalcitonin in adults with febrile neutropenia after haematopoietic stem cell transplantation
Authors: Ortega Mar , Rovira Montserrat , Filella Xavier , Almela Manel , Puig de la Bellacasa Jorge , Carreras Enric , Mensa Josep 
Published: July 2004

SummarySerum procalcitonin (PCT) levels have been proposed as a new discriminative marker for bacterial and fungal infections. We analysed the diagnostic relevance of PCT in febrile episodes of neutropenic adult patients after haematopoietic stem cell transplantation (HSCT). PCT was determined prospectively in 92 febrile episodes, classified according to the final diagnosis as: neutropenic fever of unknown origin (n = 51), microbiological (n = 26) or clinical (n = 5) documented infection and non‐infectious febrile episodes (n = 10). On first day of fever, mean (±SD) PCT level was 0·3 ng/ml (0·2) in neutropenic fever of unknown origin, 0·5 ng/ml (0·7) in microbiologically confirmed infections, 0·2 ng/ml (0·2) in clinically documented infections and 1·7 (4·2) in non‐infectious fever (P = not significant). Five days after the antibiotic therapy was started, fever persisted in 29 neutropenic episodes (32%). Cases that were eventually diagnosed with invasive aspergillosis had PCT values significantly higher [10·1 ng/ml (6·7)] than all remaining groups (P = 0·027; Kruskal–Wallis). Our analysis indicates that the PCT level on first day of fever did not facilitate the differential diagnosis of neutropenic febrile episode. However, when fever persisted for more than 5 d, PCT values ≥3 ng/ml had a high sensitivity and specificity for the diagnosis of invasive aspergillosis.
Resonance‐thrombography indices of the haemostatic process in relation to risk of incident coronary heart disease: 9 years follow‐up in the Caerphilly Prospective Heart Disease Study
Authors: Yu Shicheng , Lowe Gordon D. O. , Yarnell John W. G. , Sweetnam Peter M. 
Published: July 2004

SummaryGlobal assays, such as resonance‐thrombography (RTG), which measure the interaction between platelets, coagulation and fibrinolysis have been used as summary measures of risk for over two decades but have not been evaluated in epidemiological studies. We examined whether RTG indices are risk indicators for incident coronary heart disease (CHD). RTG indices, related haematological variables and other risk factors were measured between 1984 and 1988 in a cohort of 2398 British men. Reaction time (r) and amplitude of fibrin leg (AF) were associated with lifestyle risk factors. During 9 years of follow‐up, 282 (12%) men developed a major new CHD event, as classified by World Health Organization criteria. On adjustment for age, only r and AF measured at baseline were related to risk of incident CHD. On multivariate adjustment in a multiple logistic regression model that included age, diastolic blood pressure, body mass index, total and high‐density lipoprotein cholesterol, lifestyle risk factors and use of prescribed medicine, these associations weakened but remained significant. Additional adjustment for fibrinogen, viscosity, white cell count and fibrin d‐dimer either reduced these associations to non‐significance (AF) or to borderline significance (r).
Phenotypic sensitivity to activated protein C in healthy families: importance of genetic components and environmental factors
Authors: Taralunga Claudia , Gueguen René , Visvikis Sophie , Regnault Véronique , Sass Catherine , Siest Gérard , Lecompte Thomas , Wahl Denis 
Published: July 2004

SummaryThe relative importance of environmental factors and genetic components other than factor V Leiden on the sensitivity to activated protein C (APC) in healthy nuclear families was determined. We studied 149 European families (298 parents and 278 biological offspring aged more than 6 years). APC response was measured and expressed as normalized APC‐sensitivity ratio (n‐APC‐SR). Subjects were genotyped for G1691A and G20210A polymorphisms of factor V and II genes; levels of factors II, V and VIII, antithrombin, cholesterol, high‐density lipoprotein cholesterol and triglycerides were measured. After identifying variables influencing the n‐APC‐SR by a stepwise multiple regression model, variance component analysis was used. The heritability (proportion of the overall variability of a trait due to polygenic effects) of n‐APC‐SR was determined after adjustment for all clinical and laboratory variables, including factor V Leiden. Heritability coefficients (mean ± standard deviation) were different for males (0·68 ± 0·06) and females (0·34 ± 0·12) younger than 25 years and in subjects older than 25 years: 0·37 ± 0·09. This analysis provides strong evidence for a polygenic component influencing n‐APC‐SR in addition to factor V Leiden and suggests age‐ and gender‐specific genetic effects.