bluuebunny/crossref_metadata_2025_split huggingface dataset:
Guided tissue regeneration in human gingival recessions
Authors: Trombelli Leonardo , Minenna Luigi , Farina Roberto , Scabbia Alessandro 
Published: January 2005

AbstractObjective: The aim of the present study was to evaluate the changes of the mucogingival complex of guided tissue regeneration (GTR)‐treated gingival recession defects over a 10‐year follow‐up.Methods: The study population consisted of 20 patients, 11 males and nine females, mean age: 44.3±10.4 years, each contributing one recession defect treated with a polytetrafluoroethylene membrane. Eight patients were smokers at the time of surgery and at 10 years post‐surgery. Recession depth (RD), probing depth clinical attachment level (CAL), and width of keratinized gingiva (KG) were assessed immediately before surgery, at 6 months, 4 years and 10 years post‐surgery.Results: RD was 0.9±0.6 mm at 6 months, 1.0±1.3 mm at 4 years and 1.3±1.6 mm at 10 years. CAL amounted to 1.9±1.0 mm at 6 months and shifted to 2.2±1.4 and 2.6±1.6 mm at 4 years and 10 years, respectively. KG significantly increased following surgery and remained stable thereafter. At 10‐year examination, no significant changes from 4‐year evaluation were observed. Differences in periodontal parameters between smokers and non‐smokers were not statistically significant.Conclusion: In conclusion, the results of the present study failed to demonstrate changes over time in the clinical outcome achieved following GTR procedure in gingival recession defects over a period between 4 and 10 years post‐surgery.
Ghrelin: more than a natural GH secretagogue and/or an orexigenic factor
Authors: Ghigo E. , Broglio F. , Arvat E. , Maccario M. , Papotti M. , Muccioli G. 
Published: January 2005

SummaryGhrelin, an acylated peptide produced predominantly by the stomach, has been discovered to be a natural ligand of the growth hormone secretagogue receptor type 1a (GHS‐R1a). Ghrelin has recently attracted considerable interest as a new orexigenic factor. However, ghrelin exerts several other neuroendocrine, metabolic and also nonendocrine actions that are explained by the widespread distribution of ghrelin and GHS‐R expression. The likely existence of GHS‐R subtypes and evidence that the neuroendocrine actions, but not all the other actions, of ghrelin depend on its acylation in serine‐3 revealed a system whose complexity had not been completely explored by studying synthetic GHS. Ghrelin secretion is mainly regulated by metabolic signals and, in turn, the modulatory action of ghrelin on the control of food intake and energy metabolism seems to be among its most important biological actions. However, according to a recent study, ghrelin‐null mice are neither anorectics nor dwarfs and this evidence clearly depicts a remarkable difference from leptin null mice. Nevertheless, the original and fascinating story of ghrelin, as well as its potential pathophysiological implications in endocrinology and internal medicine, is not definitively cancelled by these data as GHS‐R1a null aged mice show significant alterations in body composition and growth, in glucose metabolism, cardiac function and contextual memory. Besides potential clinical implications for natural or synthetic ghrelin analogues acting as agonists or antagonists, there are several open questions awaiting an answer. How many ghrelin receptor subtypes exist? Is ghrelin ‘the’ or just ‘a’ GHS‐R ligand? That is, are there other natural GHS‐R ligands? Is there a functional balance between acylated and unacylated ghrelin forms, potentially with different actions? Within the next few years suitable answers to these questions will probably be found, making it possible to gain a better knowledge of ghrelin's potential clinical perspectives.
Reduced insulin sensitivity and the presence of cardiovascular risk factors in short prepubertal children born small for gestational age (SGA)
Authors: Arends N. J. T. , Boonstra V. H. , Duivenvoorden H. J. , Hofman P. L. , Cutfield W. S. , Hokken‐Koelega A. C. S. 
Published: January 2005

SummaryBackground  Epidemiological studies have shown that the metabolic syndrome, a combination of type 2 diabetes mellitus, hypertension, dyslipidaemia and a high body mass index (BMI), occurs more frequently among adults who were born with a low birth weight. Because insulin is thought to play a key role in the pathogenesis of this syndrome we investigated insulin sensitivity and risk factors for cardiovascular disease in short prepubertal children born small for gestational age (SGA).Patients and Methods  Frequently sampled intravenous glucose tolerance tests (FSIGT) were performed in 28 short prepubertal children born SGA. Short stature was defined as a height < –2SD. SGA was defined as a birth length and/or a birth weight for gestational age < –2SD. Twelve short children born appropriate for gestational age (AGA) were used as controls for the FSIGT's results only. AGA was defined as a birth weight and/or birth length for gestational age > –2SD. In short SGA children, blood pressure (BP), fasting levels of serum free fatty acids (FFA), triglycerides (TG), total cholesterol (TC), high‐density lipoprotein (HDL) cholesterol and low‐density lipoprotein (LDL) were measured and compared to reference values.Results  Mean insulin sensitivity (Si) level in short SGA children was significantly reduced to 38% of the mean Si level measured in short AGA controls (P = 0·004). Mean acute insulin response (AIR) was significantly higher in SGA children compared to short AGA controls (P < 0·001). Differences in Si and AIR between the two groups remained significant after adjusting for age and BMI (P < 0·001 and P = 0·003, respectively). The mean (SD) systolic BP SDS was 1·3 (1,1), being significantly higher than zero. Mean fasting serum levels of FFA, TC, TG, HDL and LDL were all within the normal range. However, 6 of the 28 SGA children had serum FFA levels above the normal range. Cardiovascular risk factors could statistically be represented in two clusters. Both clusters played a significant role in the development of insulin insensitivity (1/Si).Conclusion  Although the metabolic syndrome has been described in adulthood, our study showed that risk factors for the development of type 2 diabetes mellitus and cardiovascular disease are already present during childhood in short prepubertal children born SGA, suggesting a pretype 2 diabetes mellitus phenotype.
Altered ghrelin and peptide YY responses to meals in bulimia nervosa
Authors: Kojima Shinya , Nakahara Toshihiro , Nagai Nobuatsu , Muranaga Tetsuro , Tanaka Muneki , Yasuhara Daisuke , Masuda Akinori , Date Yukari , Ueno Hiroaki , Nakazato Masamitsu , Naruo Tetsuro 
Published: January 2005

SummaryObjective  In recent years great advances have been made in our understanding of the peripheral signals produced within the gastrointestinal tract that regulate appetite, such as ghrelin and peptide YY (PYY). While ghrelin elicites hunger signals, PYY elicites satiety. Therefore, alterations in hormone physiology may play a role in the pathogenesis of bulimia nervosa (BN). In this study, we investigated the postprandial profile of ghrelin and PYY levels in patients with BN.Design and patients  Postprandial plasma ghrelin and PYY levels and insulin and glucose responses were measured in 10 patients with BN and 12 control patients in response to a standard 400 kcal meal.Results  Basal ghrelin levels present in BN subjects (265·0 ± 25·5 pmol/l) were significantly higher than those in healthy controls (199·3 ± 18·4 pmol/l, P < 0·05), while basal PYY levels were equivalent in BN (14·6 ± 1·3 pmol/l) and control (12·8 ± 1·1 pmol/l, P = 0·30) subjects. Postprandial ghrelin suppression (decremental ghrelin area under the curve) was significantly attenuated in BN patients, compared to controls (−96·3 ± 26·8 pmol/l × 3 h vs. −178·2 ± 25·7 pmol/l × 3 h, P < 0·05). After a meal, the incremental PYY area under the curve in BN patients was significantly blunted from that observed in controls (9·2 ± 2·6 pmol/l × 3 h vs. 26·8 ± 3·2 pmol/l × 3 h, P < 0·01).Glucose and insulin responses to meals were similar between the two groups.Conclusions  BN patients exhibit elevated ghrelin levels before meals with reduced ghrelin suppression after eating. In bulimia nervosa subjects, the rise in PYY levels after meals is also blunted. A gut–hypothalamic pathway involving peripheral signals, such as ghrelin and PYY, may be involved in the pathophysiology of BN.
The impact of acute elevation of non‐esterified fatty acids on insulin sensitivity and secretion in women with former gestational diabetes
Authors: McLachlan K. A. , Alford F. P. 
Published: January 2005

SummaryObjectives  Elevations in non‐esterified fatty acids (NEFA) have been shown to decrease insulin action and secretion, and are a risk factor for the development of Type 2 diabetes. As women who have had gestational diabetes (GDM) are at increased risk of diabetes, we examined the effect of an acute elevation of NEFA on insulin secretion and action in these women.Patients and design  Nineteen women with recent former GDM and 19 age‐ and BMI‐matched postpartum healthy control subjects underwent a 40‐min intravenous glucose tolerance test, with and without a preceding 2‐h infusion of 20% Intralipid. Insulin action was assessed by glucose disappearance (Kg) and insulin sensitivity (SI); insulin secretion by first phase insulin release (FPIR) and disposition index (DI).Results  NEFA levels were similarly elevated in both groups by the Intralipid infusion (up to 1·140 ± 0·03 mm). As expected, the lipid infusion significantly reduced Kg (2·15 ± 0·13 vs. 1·69 ± 0·09/min, P < 0·001) and SI (3·14 ± 0·28 vs. 2·13 ± 0·17/min/mUl/min, P < 0·001) in all subjects, and these were significant within the GDM and control subgroups. FPIR was elevated in the Intralipid study in the total group of women (4·50 ± 0·50 vs. 5·02 ± 0·53, P = 0·02), but DI was significantly reduced (12·13 ± 1·1 vs. 8·83 ± 0·7, P < 0·001). There was no significant difference, however, in the absolute or percentage change in Kg, SI or FPIR with lipid infusion between the GDM and control groups. GDM status was not a predictor of the response of Kg, SI or FPIR to lipid infusion, rather, adiposity (% fat), average fasting NEFA levels and basal disposition index were associated.Conclusion  These data suggest that women with former gestational diabetes, in contrast to other prediabetic states, are not more susceptible to the deleterious effects of an acute elevation in nonesterified fatty acids than matched control subjects.
Rosiglitazone improves insulin sensitivity and glucose tolerance in subjects with impaired glucose tolerance
Authors: Hung Yi‐Jen , Hsieh Chang‐Hsun , Pei Dee , Kuo Shi‐Wen , Lee Jiunn‐Tay , Wu Ling‐Yi , He Chih‐Tsueng , Lee Chien Hsing , Fan Sandra Chyi , Sheu Wayne Huey‐Herng 
Published: January 2005

SummaryObjective  This study was designed to evaluate the effects of rosiglitazone (ROS) on insulin sensitivity, β‐cell function, and glycaemic response to glucose challenge and meal in subjects with impaired glucose tolerance (IGT).Methods  Thirty patients with IGT (ages between 30 and 75 years and BMI (body mass index) ≤ 27 kg/m2) were randomly assigned to receive either placebo (n = 15) or ROS (4 mg/day) (n = 15). All participants underwent a 75‐g oral glucose tolerance test (OGTT), meal test, and frequently sampled intravenous glucose tolerance test (FSIGT) before and after the 12‐week treatment.Results  After 12 weeks of ROS treatment, there were significant increases in total cholesterol (TC) (4·25 ± 0·22 vs 4·80 ± 0·17 mmol/l, P < 0·001), high‐density lipoprotein cholesterol (HDL‐C) (1·25 ± 0·07 vs 1·43 ± 0·06 mmol/l, P < 0·05), and low‐density lipoprotein cholesterol (LDL‐C) (2·70 ± 0·15 vs 3·37 ± 0·17 mmol/l, P < 0·05) without changes in triglyceride concentration, TC/HDL‐C and LDL‐C/HDL‐C ratio. Although the acute insulin response (AIR) to intravenous glucose and disposition index (measured as the ability of pancreatic β‐cell compensation in the presence of insulin resistance) remained unchanged, the insulin sensitivity (SI) and glucose effectiveness (SG) were remarkably elevated (0·38 ± 0·06 vs 0·54 ± 0·09 × 10−5 min−1/pmol, P < 0·05; 0·017 ± 0·002 vs 0·021 ± 0·001 min−1, P < 0·05, respectively) in the ROS group. The glucose, insulin, and c‐peptide areas under curve (AUC) in response to OGTT and the glucose and insulin AUC during meal were significantly ameliorated in the ROS group. Five out of 15 (33%) and two out of 15 (13%) subjects treated with ROS and placebo, respectively, reversed to normal response during OGTT (P < 0·05).Conclusion  Rosiglitazone treatment significantly improved insulin resistance and reduced postchallenge glucose and insulin concentrations in patients with impaired glucose tolerance without remarkable effects on β‐cell secretory function.
Circulating osteoprotegerin and receptor activator of NF‐κB ligand system are associated with bone metabolism in middle‐aged males
Authors: Oh Ki Won , Rhee Eun Jung , Lee Won Young , Kim Sun Woo , Baek Ki Hyun , Kang Moo Il , Yun Eun Joo , Park Cheol Young , Ihm Sung Hee , Choi Moon Gi , Yoo Hyung Joon , Park Sung Woo 
Published: January 2005

SummaryObjective  Osteoporosis is a growing health problem in males as well as in females. Sex hormones and insulin‐like growth factor‐I (IGF‐I) have been shown to be the major determinants in male bone metabolism. Osteoprotegerin (OPG) is a recently identified cytokine that acts as a decoy receptor for the receptor activator of NF‐κB ligand (RANKL). OPG and RANKL have been shown to be important regulators of osteoclastogenesis. However, the relationship between the OPG‐RANKL system and male bone status in human populations are unclear. Thus, the aim of this study was to investigate the relationship between the OPG‐RANKL system and bone mineral metabolism in males.Patients and Measurements  Serum concentrations of OPG, RANKL, oestradiol, total testosterone and IGF‐I and bone mineral density (BMD) were measured in 80 Korean males aged 42–70 (mean age, 54·5 year). Enzyme‐linked immunosorbent assays were used to determine the serum concentrations of OPG and RANKL. Serum concentrations of oestradiol, total testosterone, IGF‐I and bone turnover markers were determined using standard methods. BMD at the lumbar spine and femoral neck were measured by dual energy X‐ray absorptiometry.Results  We observed a significant negative correlation between the serum OPG levels and lumbar spine BMD (r =−0·259, P < 0·05) in Spearman correlation analysis. Serum OPG levels and RANKL/OPG ratios were found to be significantly correlated to the serum osteocalcin levels (r =− 0·254, P < 0·05; r = 0·264, P < 0·05) in Spearman correlation analysis. Serum OPG levels were found to be negatively correlated with serum oestradiol levels (r =−0·319, P < 0·01) in Spearman correlation analysis. In addition, a significant positive correlation was found between serum RANKL/OPG ratios and oestradiol levels (r = 0·374, P < 0·001) in Spearman correlation analysis. In contrast, Serum total testosterone and IGF‐I levels were not correlated with serum OPG levels or RANKL to OPG ratios in Spearman correlation analysis. In a multiple regression analysis, age, body mass index (BMI), and serum OPG levels were identified as a significant predictor for lumbar spine BMD, and age, BMI, serum OPG and RANKL levels for femoral neck BMD. In another multiple regression analysis, only serum oestradiol level was identified as a significant predictor for serum OPG or RANKL levels. In contrast, Serum total testosterone and IGF‐I levels were not correlated with serum OPG or RANKL levels in multiple regression analysis.Conclusions  Our data show that the circulating OPG‐RANKL system is associated with bone metabolism in the male populations. Also, our data suggest that OPG and RANKL may be mediators of the effects of oestradiol in male bone metabolism.
Advanced heart failure: impact on older patients and informal carers
Authors: Aldred Hazel , Gott Merryn , Gariballa Salah 
Published: January 2005

Aim.  This paper reports a study exploring the impact of advanced heart failure on the lives of older patients and their informal carers.Background.  Prognosis is poor in heart failure, with more than a third of patients dying within 12 months of diagnosis, and end‐of‐life symptoms are distressing and poorly controlled. Although end‐of‐life care for people with heart failure has received increased attention in recent years, there are still few data on the impact of advanced heart failure on the lives of patients and their informal carers.Methods.  Focused interviews were conducted with 10 older people with advanced heart failure and their nominated informal carer identified from one district general hospital in the United Kingdom (UK). Joint interviews were conducted with patients and carers in their own home. Thematic analysis was used to identify themes and subthemes.Findings.  Heart failure affected all aspects of the lives of patients and carers and, in particular, curtailed everyday activities. Patients were very concerned about the ‘burden’ their illness placed on their carer, who in all cases was their partner, although carers did not conceptualize the situation in this way. The socially isolating influence of the condition on both patients and carers was compounded by lack of professional input, and confusion about diagnosis was evident. Concerns about the future were common and, although few participants reported having been explicitly told about their prognosis, many made realistic statements about their limited life expectancy.Conclusions.  This older cohort of people suffering from heart failure appears to have needs not unlike those of patients with ‘terminal diseases’. When people are diagnosed with more familiar terminal illnesses, in particular cancer, they are given ongoing explanations, reassurance and support. Similar professional input is needed for patients with advanced heart failure and their carers.
Sense of coherence, coping and quality of life following a critical illness
Authors: Fok See Kee , Chair Sek Ying , Lopez Violeta 
Published: January 2005

Aim.  This paper reports the findings of a study exploring the relationships among patients’ sense of coherence, coping ability and health‐related quality of life following a critical illness.Background.  Sense of coherence is a strong determinant of positive health outcomes and successful coping. Promoting sense of coherence has been used for health promotion in the general public so that better coping ability will be achieved and, thus, better quality of life. There have been limited studies focusing on these aspects in critically ill patients, particularly during the weeks following discharge from intensive care units.Methods.  Based on the salutogenic theoretical framework, a descriptive, correlational research design using telephone interviews was used. Participants’ outlook on life, quality of life and coping responses were measured using Chinese versions of Sense of Coherence scale, SF‐36 and Coping Scale, respectively.Results.  Eighty‐eight people participated in the study. Sense of coherence was significantly correlated with quality of life (r = 0·28–0·69) and with coping ability (r = 0·58). Furthermore, coping ability was significantly correlated with six (r = 0·25–0·52) out of the eight dimensions of quality of life. It was also found that high household income and support from adult children were predictors of strong sense of coherence.Conclusion.  Patients with a strong sense of coherence are likely to take an active role in shaping their own health outcomes. The results of this study will enable nurses to design interventions in the early phase of hospitalization to enhance patients’ sense of coherence and coping abilities following a critical illness so that quality of life can be promoted.
A theory of maternal engagement with public health nurses and family visitors
Authors: Jack Susan M. , DiCenso Alba , Lohfeld Lynne 
Published: January 2005

Background.  Home visiting by public health nurses and family visitors is promoted as an important intervention for enhancing parent and child development. Mothers of children at‐risk for developmental delays tend to be the most difficult to access and engage, and commonly drop out of home visiting programmes prematurely.Purpose.  This paper reports a study developing a theory that describes the process by which mothers of children at‐risk engage with public health nurses and family visitors in a blended home visiting programme.Methods.  Grounded theory was used to guide the collection, recording, organization and analysis of the data. A purposeful sample of 20 mothers receiving public health nurse and family visitor home visits were recruited from a public health unit in Canada. Data were collected through client record reviews and 29 in‐depth interviews that explored participants’ experiences, beliefs and expectations about engagement. Data collection and analysis continued until all categories were saturated.Findings.  Mothers felt vulnerable and frequently powerless when they allowed the service providers into their home. Mothers with children at‐risk engage with public health nurses and family visitors through a basic social process of limiting family vulnerability, which has three phases: (1) overcoming fear; (2) building trust; and (3) seeking mutuality. The personal characteristics, values, experiences and actions of the public health nurse, family visitor and mother influence the speed at which each phase is successfully negotiated and the ability to develop a connected relationship.Conclusion.  Public health nurses working with families at risk need to identify client fears and perceptions related to home visiting, and to explain the role of public health nurses and family visitors to all family members. Given the importance that mothers place on the development of an interpersonal relationship, it is important for home visitors continually to assess the quality of their relationships with clients.
Role development and effective practice in specialist and advanced practice roles in acute hospital settings: systematic review and meta‐synthesis
Authors: Jones Myfanwy Lloyd 
Published: January 2005

Aims.  This paper reports a study whose aim was to identify and synthesize qualitative research studies reporting barriers or facilitators to role development and/or effective practice in specialist and advanced nursing roles in acute hospital settings.Background.  The number of clinical nurse specialist, nurse practitioner, advanced nurse practitioner and consultant nurse roles has grown substantially in recent years. Research has shown that nurses working in innovative roles encounter a range of barriers and facilitators to effective practice.Methods.  Systematic literature searches were undertaken, and relevant studies identified using specific inclusion and exclusion criteria. The selected studies were appraised, and their findings synthesized using Ritchie and Spencer's ‘Framework’ approach.Results.  Fourteen relevant studies were identified, mostly from the UK. They described a range of barriers and facilitators affecting specialist and advanced nursing practice. These related to the practitioner's personal characteristics and previous experience, professional and educational issues, managerial and organizational issues, relationships with other health care professionals, and resources. The factors most widely identified as important were relationships with other key personnel, and role definitions and expectations.Conclusions.  Relationships with other staff groups and role ambiguity are the most important factors which hinder or facilitate the implementation of specialist and advanced nursing roles. These factors seem interlinked, and the associated problems do not appear to resolve spontaneously when staff become familiar with the new roles. In order to reduce role ambiguity and the consequent likelihood of negative responses we recommend that, when specialist and advanced nursing roles are introduced, clear role definitions and objectives are developed and communicated to relevant staff groups; these definitions and objectives should be updated as necessary.