bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship of skin‐prick reactivity to aeroallergens and hyperresponsiveness to challenges with methacholine and adenosine monophosphate
Authors: Fowler Stephen J. , Lipworth Brian J. 
Published: March 2003

Background: Clarification of the relationship between atopy and bronchial hyperresponsiveness (BHR), both key features of asthma, is critical to our understanding of the disease. We therefore investigated the putative relationship between skin‐prick reactivity to aeroallergens and BHR to direct and indirect stimuli.Methods: We performed a retrospective analysis of data from 332 patients presenting with a diagnosis of asthma. Patients were characterized by skin prick tests (SPT), spirometry and bronchial challenge with methacholine and adenosine monophosphate (AMP).Results: For patients who had BHR to methacholine but not AMP, the presence of atopy was associated with a lower PD20 (the provocative dose of methacholine producing a fall in FEV1 of 20%), amounting to a geometric mean (95% confidence interval (CI)) of 2.3‐fold (1.4–4.0) difference. Furthermore, the number of skin‐prick positive (SPP) responses was related to methacholine reactivity: 0–1 SPP, PD20 = 69.9 µg; 2–4 SPP, PD20 = 47.8 µg; 5–8 SPP, PD20 = 35.6 µg. There was a 2.0‐ fold (1.1–3.6) difference between the groups with a low (0–1 SPP) and high (5–8 SPP) degree of skin‐prick reactivity. A similar pattern was seen when data were analyzed including only perennial allergens. Spirometry was unrelated to the degree of skin‐prick reactivity.Discussion: These results suggest that skin‐prick reactivity to aeroallergens is associated with BHR to methacholine.
Nuclear factor‐κB activity is down‐regulated in nasal polyps from aspirin‐sensitive asthmatics
Authors: Picado C. , Bioque G. , Roca‐Ferrer J. , Pujols L. , Mullol J. , Benitez P. , Bulbena O. 
Published: March 2003

Background: We examined whether a decreased activity of nuclear factor(NF)‐κB), a transcriptional regulator of cyclooxygenase‐2 (COX‐2), could account for down‐regulation of COX‐2 in nasal polyps of aspirin‐sensitive asthmatics.Methods: Nasal polyps were obtained from 17 aspirin‐intolerant asthma/rhinitis patients (AIAR; 7 men, mean age 48 ± 12 years) and 23 aspirin‐tolerant asthma/rhinitis patients (ATAR; 12 men, mean age 65 ± 11 years). COX‐2 mRNA expression was measured using semiquantitative reverse transcriptase competitive polymerase chain reaction (RT‐PCR), and the results were expressed as mean ± standard error of 106 molecules of mRNA/µg of total RNA. NF‐κB binding was measured with 32P‐labeled oligonucleotides and electrophoretic mobility shift assay (EMSA), and the results were expressed as a percentage with respect to the mean EMSA obtained in 19 healthy nasal mucosa.Results: The mean levels of COX‐2 mRNA expression (0.25 ± 0.06) and NF‐κB activity (89 ± 13) in nasal polyps from AIAR were significantly lower than in polyps from ATAR (COX‐2 = 1.58 ± 0.50, and NF‐κB = 143 ± 12, P < 0.01 and P < 0.05, respectively). Levels of COX‐2 mRNA and NF‐κB activity in polyps from patients on corticosteroid therapy did not differ statistically from those who were not on this therapy before polypectomy.Conclusion: This study shows that the low expression of COX‐2 mRNA in nasal polyps from aspirin‐sensitive patients is associated with a down‐regulation of NF‐κB activity.
Participation rates of Ashkenazi Jews in a colon cancer community‐based screening/prevention study
Authors: Cappelli M , Hunter AGW , Stern H , Humphreys L , Van Houten L , O'Rourke K , Viertelhausen S , Perras H , Lagarde AE 
Published: March 2003

In a recent colon cancer risk study, genetic assessment and colonoscopy were offered to virtually all of the adult Ashkenazi Jews in an urban community. The present study was designed to examine factors influencing participation and response in the initial study and to suggest strategies for improving participation in future health promotion programs.The study comprised a random sample of three groups of individuals who had been targeted for participation in the previous study: those who had (a) agreed to participate (n = 234); (b) declined participation (n = 179); and (c) failed to respond to a mailed recruitment package (n = 128). All participants completed a brief telephone survey.Key multivariate predictors of both response and participation were individuals' perceptions of the drawbacks of participating in colon cancer screening research and the degree of decisional conflict they experienced. Response was further predicted by the influence of spouses, family history of colon cancer, past knowledge of genetic testing for colon cancer, and education level. Participation was predicted by awareness that the study was supported by the Ashkenazi Jewish community, past experience with genetic testing, individuals' perceptions of the benefits of participating, and whether or not they had children.The degree to which individuals understand the purpose and nature of genetic screening research, along with their levels of decisional conflict and other psychosocial factors, may influence the likelihood of their participation in such research. Results of this study suggest a number of possible strategies for improving participation and response rates in disease prevention and detection studies.
Association between G−308A polymorphism of the tumor necrosis factor‐α gene and 24‐hour ambulatory blood pressure values in type 1 diabetic adolescents
Authors: Krikovszky D , Vásárhelyi B , Tóth‐Heyn P , Körner A , Tulassay T , Madácsy L 
Published: March 2003

Krikovszky D, V´s´rhelyi B, Tóth‐Heyn P, Körner A, Tulassay T, Madácsy L. Association between G−308A polymorphism of the tumor necrosis factor‐α gene and 24‐hour ambulatory blood pressure values in type 1 diabetic adolescents.  Clin Genet 2002: 62: 474–477. © Blackwell Munksgaard, 2002Tumor necrosis factor‐α (TNF‐α) is an inflammatory cytokine, which also influences blood pressure (BP). The G−308A polymorphism of the TNF‐α gene is associated with altered TNF‐α production. The prevalence of the TNF‐α−308A allele is reportedly higher among patients with type 1 diabetes mellitus (T1DM) than in the healthy population. In this study we investigated whether this genetic polymorphism might correlate with BP values in diabetic adolescents. Ambulatory BP monitoring (ABPM) was performed in 126 adolescents with T1DM (mean age: 14 ± 2.4 years). The TNF‐α G−308A genotype was determined by using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) methodologies. ABPM results were related to healthy reference values and are given as standard deviation score (SDS). The prevalence of the −308A allele was higher in diabetic adolescents than the Hungarian reference population (0.26 vs 0.14, p < 0.01). TNF‐α genotype was associated both with systolic and diastolic BP values (p < 0.01 and p < 0.01, respectively). In patients with TNF‐α−308GG and −308GA/AA genotypes, the 24‐h systolic BP average values were 0.37 ± 1.33 and −0.38 ± 1.28 SDS, while 24‐h diastolic BP average values were 0.09 ± 1.30 and −0.67 ± 1.31 SDS. Hence, the TNF‐α−308A allele carrier state appears to be associated with lower systolic and diastolic BP values.
Prevalence and ethnic differences of autosomal‐dominant cerebellar ataxia in Singapore
Authors: Zhao Y , Tan EK , Law HY , Yoon CS , Wong MC , Ng I 
Published: March 2003

Zhao Y, Tan EK, Law HY, Yoon CS, Wong MC, Ng I. Prevalence and ethnic differences of autosomal‐dominant cerebellar ataxia in Singapore.  Clin Genet 2002: 62: 478–481. © Blackwell Munksgaard, 2002We report the prevalence and ethnic differences of autosomal‐dominant cerebellar ataxia (ADCA) in Singapore. Amongst 204 patients with ataxia who underwent genetic testing for dentatorubral‐pallidoluysian atrophy (DRPLA) and for spinocerebellar ataxias (SCA) 1, 2, 3, 6, 7, 8, 10 and 12, 58 (28.4%) patients from 36 families tested positive. SCA 3 was identified in 31 (53.4%) patients from 15 families, SCA 2 in 17 (29.3%) patients from 12 families and SCA 1 in four (6.9%) patients from four families. Other SCA subtypes were rare. SCA 2 was the only subtype identified amongst ethnic Malay and ethnic Indian families. The estimated prevalence of ADCA in Singaporean families was at least 1 : 27,000. Based on the history and ancestry of Singaporeans, our study supported a founder effect for specific SCA subtypes and the association of ethnicity‐specific SCA subtypes. Our findings suggest that SCA 2 is relatively common amongst the Malay race and that priority testing for SCA 3 and SCA 2 for ethnic Chinese, and SCA 2 for ethnic Malay, may be cost effective and relevant for the region.
A case of persistent acute allograft glomerulopathy with long‐standing stable renal function
Authors: Katafuchi Ritsuko , Masutani Kousuke , Mizumasa Tohru , Fujita Emi , Tanaka Hiroshi , Ikeda Kiyoshi , Yanase Tetsuro , Ando Takashi , Fujimi Satoru 
Published: March 2003

Katafuchi R, Masutani K, Mizumasa T, Fujita E, Tanaka H, Ikeda K, Yanase T, Ando T, Fujimi S. A case of persistent acute allograft glomerulopathy with longstanding stable renal function. Clin Transplantation 2001: 15 (Supplement 5): 2–10. ©Munksgaard, 2001Acute allograft glomerulopathy (AAG) characterized by hypercellularity, enlargement of endothelial cells, infiltration of glomeruli by mononuclear cells and webs of PAS‐positive material has been reported as an unusual but distinct form of acute rejection in kidney transplant recipients. We present a case of persistent AAG proven by serial biopsies. The patient was 53 years old when she received kidney transplantation from her mother. The immunosuppressants were methylprednisolone, azathioprine and FK506. She developed several acute rejections and received antirejection therapy. The patient transferred to our hospital 15 months after transplantation. Serum creatinine was 2.11 mg/dL. The level of serum creatinine was gradually elevated from 2.11 mg/dL to 3.09 mg/dL. Graft biopsy, performed 16.5 months after transplantation, represented prominent intraglomerular infiltration of mononuclear cells, segmental thickening of glomerular basement membrane (GBM) with double contour, grade 1 tubulitis, marked accumulation of mononuclear cells in peritubular capillaries and margination of mononuclear cells in a small artery. It was diagnosed as acute allograft glomerulopathy (AAG). Intravenous methylpredniso‐lone pulse therapy, discontinuation of FK506 and administration of cyclosporin (CYA) resulted in decrease of serum creatinine. To evaluate histological evolution of AAG we performed two sub‐sequent biopsies over 3 yr. Severe glomerulitis persisted as a prom‐inent feature 8 months later and still existed 53.4 months after transplantation with decreased severity. The extent of GBM reduplication also decreased, but the percentage of glomerular sclerosis increased gradually. Multi‐layering of basement membrane of peritubular capillary and interstitial fibrosis also increased. The prominence of infiltration of mononuclear cells in peritubular capillary was unchanged. At the last follow‐up, i.e. 71 months after transplantation, her serum creatinine was 1.34 mg/dL. Neither proteinuria nor haematuria was observed. We consider that our immunosuppressive treatment has been successful so far, because the patient is still maintaining stable graft function since the transplantation over 6 yr ago. It is thus suggested that AAGper seprobably has no influence on acute aggravation of graft function, but AAG and capillaritis in peritubular capillaries may cause an evolution of chronic allograft nephropathy, resulting in a slowly progressive deterioration of graft function.
Influence of dialysis on post‐transplant events
Authors: Joseph JT , Jindal RM 
Published: March 2003

Introduction: We examined the effect of haemodialysis (HD) or peritoneal dialysis (PD) on acute rejection, delayed graft function (DGF), graft and patient survival after cadaveric renal transplantation. Materials and methods: We carried out a retrospective analysis of 325 patients (cyclosporin [CyA]‐based therapy) who had their first cadaver renal transplant between January 1991 and December 1996 and followed up for a mean of 61 ± 26 months. They were divided into three groups: HD, PD and CD (where both PD and HD was used for at least 3 months). Delayed graft function was diagnosed if the patient needed dialysis in the first week post‐transplant while primary non‐function (PNF) was diagnosed if the kidney never achieved function. Graft rejection was confirmed by biopsy; early acute rejection (EAR) was defined as acute rejection occurring before 90 days and late acute rejection (LAR) as one after 90 dResults: A total of 183 patients had PD, 117 HD and 25 CD. The mean time period in which the patients were on dialysis for PD was 24 months, HD 34.5 months and CD 50.6 months (p < 0.01). The recipients were matched for age and gender. The donor variables (age, gender and cold ischaemia time) did not differ between the groups. The mean time for the development of first acute rejection following renal transplant in each group was as follows: PD group: 68.8 d, HD group: 81.3 d and CD group: 105 d (p=0.08). The number of patients who developed EAR was 90 (49.2%) in PD group, 51 (43.6%) in HD group and 11 (56%) in CD group (p=0.6); the number who developed LAR was nine in PD group (4.9%), six in HD group (5.1%) and one in CD group (4%) (p=0.9). Fifty‐six patients with PD had DGF compared with 58 with HD (p=0.01). There was no difference in the number and severity of rejection episodes or DGF based on the duration of dialysis. The 5‐yr survival of patients was 79% for PD, 81% HD and 78% CD groups (p=n.s), while the graft survival for PD group was 61%, HD group 63% and CD group 74% (p=n.s). Summary: We could find no difference in the patient or graft survival between patients who had pre‐transplant HD, PD or CD. There was no difference in the incidence of acute rejection episodes between the three groups of patients as well. However, we found a significantly higher rate of DGF in the HD versus PD patients.
Infectious disease prophylaxis in renal transplant patients: a survey of US transplant centers
Authors: Batiuk Thomas D , Bodziak Kenneth A , Goldman Mitch 
Published: March 2003

Definitive approaches to most infectious diseases following renal transplantation have not been established, leading to different approaches at different transplant centers. To study the extent of these differences, we conducted a survey of the practices surrounding specific infectious diseases at US renal transplant centers.A survey containing 103 questions covering viral, bacterial, mycobacterial and protozoal infections was developed. Surveys were sent to program directors at all U.S. renal transplant centers.Responses were received from 147 of 245 (60%) transplant centers and were proportionately represented all centers with respect to program size and geographical location. Pre‐transplant donor and recipient screening for hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV) and cytomegalovirus (CMV) is uniform, but great discrepancy exists in the testing for other agents. HCV seropositive donors are used in 49% of centers. HIV seropositivity remains a contraindication to transplantation, although 13% of centers indicated they have experience with such patients. Post‐transplant, there is wide variety in approach to CMV andPneumocystis carinii(PCP) prophylaxis. Similarly divergent practices affect post‐transplant vaccinations, with 54% of centers routinely vaccinating all patients according to customary guidelines in non‐transplant populations. In contrast, 22% of centers indicated they do not recommend vaccination in any patients.We believe an appreciation of the differences in approaches to post‐transplant infectious complications may encourage individual centers to analyse the results of their own practices. Such analysis may assist in the design of studies to answer widespread and important questions regarding the care of patients following renal transplantation.
Present and future role of Mental Illness Advocacy Associations in the management of the mentally ill: realities, needs and hopes at the edge of the third millennium
Authors: Morselli Paolo Lucio 
Published: March 2003

Objective:

The purpose of the present review is the analysis of the development and current status of the Mental Illness Advocacy Movement in the USA and in Europe, as well as of the role such a movement is playing in the management of the mentally ill.

Methods: Information on the issue has been collected via literature search and several personal inquiries and contacts with different Mental Illness Advocacy Groups in the USA and in Europe.

Results: The findings indicate that the Mental Illness Advocacy Movement is very alive and in full growth. Its role in the management of the mentally ill has become more and more important over the years. In several countries, it makes it possible to overcome some of the deficiencies of the National or Private Health Services. Thanks to the actions of the various Mental Illness Advocacy Groups, today, patients and families are more and better informed of their conditions and their rights. In many cases, this results in earlier diagnosis, better compliance and better outcomes. However, despite significant improvement in the status of the mentally ill patient, much still remains to be done.

Conclusions: We need an improved dialogue with mental heath providers, public administrators, mental health policy makers, mass media and politicians. The dialogue between primary care team and the specialist must also be improved. A global alliance for action is needed to ensure better and more available services to those who suffer from mental disorders.
A pilot study of concordance therapy for individuals with bipolar disorders who are non‐adherent with lithium prophylaxis
Authors: Scott Jan , Tacchi Mary Jane 
Published: March 2003

Objectives:  To assess the acceptability and feasibility of concordance therapy (CCT) in improving adherence with lithium prophylaxis in individuals with bipolar disorder.Methods:  Ten subjects with bipolar I disorder and self‐reported problems with lithium adherence were recruited. Eight participated in a 6‐month study of CCT delivered by an expert in cognitive therapy. Reliable and valid assessments of self‐reported adherence with lithium, attitudes towards, and knowledge of lithium and serum plasma lithium levels were measured pre‐ and post‐intervention. Subjects' views of CCT were also recorded.Results:  Statistically significant improvements in attitudes towards lithium (mean score baseline = 6.8; follow up = 4.1; Effect size = 1.6) were associated with improvements in self‐reported adherence. Laboratory results demonstrated statistically significant increases in serum plasma lithium levels (mean increased from 0.41 to 0.6; effect size 1.7). Subjects viewed CCT as an acceptable intervention. However, only four of the 10 subjects completed all seven half‐hour therapy sessions and homework tasks.Conclusions:  This small open study suggests that CCT may represent a useful addition to the ‘stepped care’ package of treatment for individuals with bipolar disorders. Research is underway to assess its efficacy and to establish whether novice therapists can also apply the model effectively.
The case for completing the lymphadenectomy when positive lymph nodes are found during radical hysterectomy for cervical carcinoma
Authors: KENTER GEMMA G. , HELLEBREKERS BART W. J. , ZWINDERMAN KOOS H. , VAN DE VIJVER MARK , PETERS LEX A. W. , TRIMBOS JEAN BAPTIST 
Published: March 2003

Background. In the present study we report on the results of a retrospective study on the effect on survival of the pelvic lymphadenectomy in a group of 294 patients with stage Ia2‐IIa cervical carcinoma treated by radical hysterectomy from 1984 through 1996 at the Leiden University Medical Center.Methods. Lymphadenectomy was called ‘complete’ when lymph node bearing tissue had been removed from 5 or 6 lymph node stations and ‘not‐complete’ when this was the case in 1–4 stations.Results. A radical hysterectomy was carried out in 294 patients. In 63 patients positive lymph nodes were found. Patients with positive nodes showed poorer 5 year survival: 64.5% compared to 90% in patients with negative nodes. In the univariate analysis the following factors were found to affect the presence of node metastases in a statistically significant way: age, tumor size, depth of infiltration, vaso‐invasion, surgical margins, parametrial infiltration, stage and place of referral. In 63 patients with positive nodes, a complete lymphadenectomy was carried out in 23 patients, and in 40 patients the procedure was incomplete. All 63 patients were treated by adjuvant radiation therapy; those with complete lymphadenectomy had significantly less recurrences (25%) compared to those with incomplete lymphadenectomy (56%): the relative risk (RR) was 2.9 (95% ci: 1.3–6.7), p=0.012. After adjustment for other prognostic factors including tumor size, depth of infiltration and parametrial involvement, the complete lymphadenectomy showed an independent effect on disease free survival: RR=3.2 (95% ci:1.3–7.7), p=0.011. Prognostic factors were not significantly different for patients with complete or incomplete lymphadenectomy.Conclusions. From the results of this study, although retrospective and non randomized, it can be concluded that to complete removal of lymph nodes in combination with radical hysterectomy seems to have a beneficial effect on prognosis in case of positive nodes. The policy of aborting the procedure when lymph node metastases are found in frozen section should be questioned.
Perinatal deaths in a Norwegian county 1986–96 classified by the Nordic‐Baltic perinatal classification: Geographical contrasts as a basis for quality assessment
Authors: HOLT JAN , VOLD INGAR NIKOLAI , ODLAND JON ØYVIND , FØRDE OLAV HELGE 
Published: March 2003

Background. Quality assessment of perinatal care can be carried out by classifying perinatal deaths. In the following we have analyzed the geographical contrasts in perinatal deaths according to the Nordic‐Baltic perinatal death classification in a sparsely populated Norwegian county.Material and methods. All stillbirths (≥28 weeks of gestation) and neonatal deaths (gestational age ≥22 weeks; death ≤28 days) in 1986–96 from Nordland county (240 000 inhabitants) were classified. For comparison the county was geographically divided into six general local hospital areas and one central hospital area.Results. The classification showed a well acceptable inter and intra observer variation. One hundred and seventy‐one stillbirths and 155 neonatal deaths were analyzed. The death rate (pr 1000 births) for single, non‐malformed, antenatal stillbirths was higher in the central hospital area than in the local hospital areas (3.22 vs. 2.02). The death rate for extreme preterm infants (22–27 weeks of gestation) was on the other hand higher in the local hospital areas (2.45 vs. 1.05). One of the general local hospital areas was singled out with an especially high neonatal death rate among extreme preterm infants. This was to some extent explained by the death of extreme preterm twins and triplets.Conclusion. The Nordic‐Baltic perinatal death classification system is a consistent and reproducible tool also for studying perinatal death in restricted geographical areas. The observed contrasts in perinatal deaths were used as basis for programs aimed at improving perinatal care. The observation of an unexplained increased number of antenatal stillbirths in the central hospital area resulted in a program for prospective recording and better characterization of the placenta and umbilical cord. Proposals for a better antenatal program preventing extreme preterm birth of twins for the whole county has been launched. In utero transfer to a hospital with a neonatal intensive care unit seems crucial in improving the prognosis for these infants.