bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urinary symptoms, quality of life and sexual function in patients with benign prostatic hypertrophy before and after prostatectomy: a prospective study
Authors: Gacci M. , Bartoletti R. , Figlioli S. , Sarti E. , Eisner B. , Boddi V. , Rizzo M. 
Published: March 2003

OBJECTIVETo evaluate urinary symptoms, sexual dysfunction and quality of life in patients with benign prostatic hypertrophy (BPH) before and after open prostatectomy, using the International Prostate Symptom Score (IPSS), the International Continence Society (ICS)‐‘BPH’ (ICS‐male, ICS‐sex and ICS‐QoL) and International Index of Erectile Function (IIEF) questionnaires.PATIENTS AND METHODSSixty men with BPH (mean age 68 years) underwent a digital rectal examination, transurethral ultrasonography, measurement of total prostatic specific antigen serum level and uroflowmetry. Their urinary symptoms, sexual function and quality of life were fully evaluated using the IPSS, ICS‐‘BPH’ and IIEF before and 6 months after suprapubic prostatectomy. The body mass index (BMI) was also calculated for each patient. Univariate analysis was used to examine the relationship between symptom scores and age, tobacco use, alcohol intake and BMI.RESULTSIn a univariate analysis, age was the most important prognostic factor for both urinary and sexual symptoms. Prostatectomy resulted in a significant improvement in obstructive (mean 9.68 to 3.38) and irritative symptom (6.70 to 3.06), and quality‐of‐life scores (3.41 to 1.34). ICS‐male scores were both significantly decreased, the mean voiding score from 13.72 to 10.28 and the incontinence score from 10.43 to 7.81. There was also a significant decrease in the ICS‐QoL symptom score (from 9.20 to 7.27). Comparative results between IIEF and ICS‐sex showed no improvement in sexual scores after open surgery, but there was a significant increase in sexual desire and overall satisfaction (both P = 0.035).CONCLUSIONSThe combined use of the IPSS, ICS‐‘BPH’ and IIEF allows an evaluation of the relationship between age, prostatic symptoms and sexual dysfunction. Age may be considered both a direct and indirect (BPH‐related) prognostic factor for sexual activity. Suprapubic prostatectomy resolves obstructive symptoms, and maintains sexual desire, overall sexual satisfaction and an improvement in quality of life. However, irritative symptoms, erection, orgasm and sexual intercourse satisfaction are not significantly altered.
Preoperative urodynamic and symptom evaluation of patients undergoing transurethral prostatectomy: analysis of variables relevant for outcome
Authors: Hakenberg O.W. , Pinnock C.B. , Marshall V.R. 
Published: March 2003

OBJECTIVETo assess the value of preoperative symptom score assessment and pressure‐flow measurement in men undergoing transurethral prostatectomy (TURP).PATIENTS AND METHODSIn a prospective study, 95 men (mean age 74.3 years) scheduled for TURP because of their lower urinary tract symptoms, flow rates and urinary residual volumes were assessed using the self‐administered International Prostate Symptom Score (IPSS) and urodynamic pressure‐flow studies. At 3 months after TURP the patients were reassessed with a flow rate measurement and the IPSS. The baseline IPSS and urodynamic values were analysed with respect to the endpoints of the study, flow rate and IPSS after TURP, and the improvements thereof, respectively.RESULTSThere were significant improvements in mean IPSS (− 10.87 points) and peak flow rate (+ 7.06 mL/s) 3 months after TURP. Classifying the patients into subgroups with distinctly different initial values for IPSS, flow rate, residual urine volume and degree of obstruction (as expressed by Abrams‐Griffiths number) showed that the flow rate and degree of obstruction influenced the improvement in flow rate but not in symptoms after TURP. Symptom improvement was only related to the initial level of symptoms. In a multivariate analysis, only age was an independent predictor of the outcome variables of flow rate and symptoms.CONCLUSIONSClinical decision‐making remains a valid instrument for selecting patients for TURP. Both the IPSS and pressure‐flow assessment are useful to exclude patients who are unlikely to benefit from TURP. Age is an important predictor of the improvement in symptoms and flow rates after TURP for the lower urinary tract symptom complex associated with benign prostatic enlargement.
Time after surgery, symptoms and well‐being in survivors of urinary bladder cancer
Authors: Henningsohn L. , Wijkström H. , Pedersen J. , Ahlstrand C. , Aus G. , Bergmark K. , Onelöv E. , Steineck G. 
Published: March 2003

OBJECTIVETo evaluate how an increasing burden of symptoms influences well‐being, anxiety and depression at different intervals after a radical cystectomy with urostomy for bladder cancer, as this therapy can induce long‐term distressful symptoms.PATIENTS AND METHODSPatients with bladder cancer undergoing radical cystectomy in Stockholm between 1969 and 1995 were matched with 434 controls from the normal population; all 404 patients operated on between 1985 and 1995 at three other hospitals in Sweden were invited to enter the study. The final analysis included 306 patients and 310 controls, all assessed for symptoms and well‐being.RESULTSA low or moderate level of well‐being was reported by 35% of the patients having none or one of the symptoms studied, by 39% with two symptoms, by 45% with three symptoms and by 66% of those with four or more symptoms. The values, irrespective of symptom burden, were 45% after 2–5 years of follow‐up, 58% after 6–10 years and 38% at>10 years after surgery. The total symptom burden also influenced the risk of anxiety and depression. Symptom prevalence remained largely unaffected by the duration of follow‐up, except for defecation urgency.CONCLUSIONSThe number of long‐term symptoms after radical surgery with a urostomy for urinary bladder cancer affects the risk of anxiety, depression and low or moderate well‐being.
Why do foot ulcers recur in diabetic patients?
Authors: Mantey I. , Foster A. V. M. , Spencer S. , Edmonds M. E. 
Published: March 2003

Summary Aim To investigate factors predisposing to recurrent foot ulceration in patients with diabetes mellitus. Methods Two groups of patients who had attended a specialist Diabetes Foot Centre were assessed: relapsers (n = 26), whose foot ulceration had recurred at least twice, and nonrelapsers (n = 25), whose initial ulcer had not recurred for at least 2 years. Results In the relapser group 10/26 patients waited at least 24 h before reporting symptoms compared with only 2/25 in the nonrelapser group (P < 0.05). Vibration perception threshold (volts) was 38 ± 12 (mean ± sd) in relapsers compared with 25 ± 13 in nonrelapsers (P < 0.005). Cold perception threshold (°C) was 9.1 ± 4.6 in relapsers compared with 5.1 ± 3.5 in nonrelapsers (P < 0.005). HbA1c (%) was significantly raised at 8.5 ± 1.7 in relapsers compared with 7.6 ± 1.2 in nonrelapsers (P = 0.03). Alcohol intake was 0.5 (median, interquartile range 0–2) units per day in relapsers compared with 0.0 (median, interquartile range 0–0.25) units in nonrelapsers (P = 0.04). Smoking habits, housing conditions, visual acuity, threshold for warm perception and the Doppler pressure index were not significantly different in the two groups. Conclusions Patients who develop recurrent foot ulceration delay in reporting symptoms, when compared with diabetic patients whose foot ulceration does not recur. The relapsers also have evidence of poorer glycaemic control, more neuropathy and increased alcohol intake.Diabet. Med. 16, 245–249 (1999)
Relationship between HLA‐DQ and ‐DR genotypes and clinical characteristics in a French population of Type 1 diabetic patients
Authors: Zevaco‐Mattei C. , Reviron D. , Atlan‐Gepner C. , Botti G. , Simonin G. , Lassmann‐Vague V. , Vague P. , Mercier P. , Vialettes B. 
Published: March 2003

Summary Aims The present study was designed to look for a heterogeneity in the association between Type 1 diabetes mellitus (DM) and class II alleles of major histocompatibility complex (MHC) according to clinical presentation and C‐peptide secretion during the first year of the disease, in a population living in south of France.Methods HLA DRB1 and DQB1 genotypes were determined in 129 Caucasoid patients with Type 1 DM and compared to a control group (n = 88). In a subgroup of 46 young adult diabetic patients, basal and postglucagon C‐peptide secretion was followed during the first year of the disease (at 0, 1, 3, 6, 9 and 12 months). Results The two main haplotypes associated with Type 1 DM were DRB1*04DQB1*0302 and DRB1*03DQB1*02. The genotypes DRB1* 04DQB1*0302/DRB1*04DQB1*0302 and DRB1*03DQB1*02/DRB1*04DQB1* 0302 were associated with an early onset of diabetes, while homozygosity for DRB1*03DQB1*02 was characterized by later onset. Levels of residual insulin secretion in patients genotyped DRB1*03DQA1*0501DQB1* 02/DRB1* 04DQA1*0301DQB1*0302 were higher than in patients genotyped DRB1* 3DQA1*0501DQB1*02/DRB1*XDQA1*XDQB1*X or DRB1* XDQA1* XDQB1*X/DRB1*XDQA1*XDQB1*X. Conclusions This study confirms some clinical heterogeneity of Type 1 DM linked to HLA DR and DQ genotypes, and leads to a paradoxical finding: DQB1*02/DQB1*0302 combination predisposes to an early onset in the whole population but residual secretion of insulin disappears more slowly in a subgroup of young adults with recently diagnosed diabetes. These data suggest that interrelations between MHC genotype and diabetogenic process could be different at various ages of life.Diabet. Med. 16, 201–206 (1999)
Endothelial function in offspring of Type 1 diabetic patients with and without diabetic nephropathy
Authors: McAllister A. S. , Atkinson A. B. , Johnston G. D. , McCance D. R. 
Published: March 2003

Summary Aims Familial aggregation of diabetes and nephropathy has been observed in several populations. Various interpretations have included underlying genetic mechanisms possibly mediated by a predisposition to hypertension. Endothelial dysfunction is now recognized as central to these conditions and offers a unifying mechanism to explain the disease aggregation. To test this hypothesis, we have examined endothelial function in healthy subjects at differing risks for diabetic nephropathy. Methods Endothelial function was assessed in 12 healthy offspring (nine male (M)/three female (F); age 25.8 ± 1.2 years, mean ± sem) of parents with Type 1 diabetes mellitus (DM) and end‐stage renal disease compared with 12 control offspring (9 M/3 F; age 26.3 ± 1.3 years) of parents with long duration (> 20 years) Type 1 DM but without evidence of nephropathy. Forearm blood flow responses to brachial artery infusion of acetylcholine (endothelium‐dependent), sodium nitroprusside (endothelium‐independent), noradrenaline and the competitive inhibitor of basal nitric oxide release NG‐monomethyl‐
l‐arginine were assessed using venous occlusion plethysmography.Results There were no significant differences between the groups in von Willebrand factor, fasting plasma glucose (4.2 ± 0.1 vs. 4.0 ± 0.2 mmol/l) or in 24‐h ambulatory blood pressure. Similarly, the groups did not differ in vasodilation to acetylcholine (P = 0.75) and sodium nitroprusside (P = 0.79) or in vasoconstriction to noradrenaline (P = 0.45) and NG‐monomethyl‐
l‐arginine (P = 0.30). Conclusion These data do not support a role for endothelial dysfunction in the familial aggregation of diabetic nephropathy.Diabet. Med. 16, 298–303 (1999)
Angiotensin‐converting enzyme gene and diabetes mellitus
Authors: Kennon B. , Petrie J. R. , Small M. , Connell J. M. C. 
Published: March 2003

Summary Aims The association of the insertion/deletion polymorphism in the angiotensin‐converting enzyme (ACE) gene with cardiovascular disease and diabetic nephropathy remains a controversial issue. This review aims to give an overview of the research to date assessing the impact of the ACE polymorphism in Type 1 and Type 2 diabetes mellitus (DM). Methods A systematic review of the literature was performed in the databases of MEDLINE, PubMed and EMBASE for the key words ‘diabetes mellitus’, ‘diabetic nephropathy’, ‘ACE polymorphism’ and ‘genotype’ and relevant articles were considered. Results A meta‐analysis assessing the influence of the ACE polymorphism on disease susceptibility demonstrated significant odds ratios in individuals with the DD genotype for coronary heart disease, myocardial infarction and both diabetic and nondiabetic renal disease. No association was found for left ventricular hypertrophy or hypertension in nondiabetic subjects. Conclusions The ACE polymorphism appears to have a significant impact on the progression of diabetic nephropathy and may have therapeutic implications for identifying those individuals resistant to the effects of ACE inhibitors. It also appears to be indicative of an increased vascular risk in diabetic patients; however, larger prospective studies are required to clarify this situation.
Susceptibility of low‐ and high‐density lipoproteins from diabetic subjects to in vitro oxidative modification
Authors: Julier K. , Mackness M. I. , Dean J. D. , Durrington P. N. 
Published: March 2003

Summary Aims To investigate the hypothesis that lipid peroxidation of both low‐density lipoproteins (LDL) and high‐density lipoproteins (HDL) is important in the development of atherosclerosis. Methods We have investigated whether LDL and HDL from patients with Type 1 diabetes mellitus (DM, n = 16) and Type 2 DM (n = 15) is more susceptible to Cu2+‐induced lipid peroxidation than LDL and HDL from a similar number of nondiabetic controls matched for age, gender and serum cholesterol. Results The vitamin E content of LDL and HDL from both groups of diabetic patients was not significantly different from controls. The LDL from Type 2 diabetic patients and HDL from both diabetic groups were significantly richer in triglyceride than controls. Phospholipid was decreased in LDL from Type 2 diabetic patients and protein was decreased in HDL in Type 1 DM, but otherwise the composition of LDL and HDL in diabetic subjects was similar to controls. No significant differences were observed in the generation of conjugated dienes or lipid peroxides in either LDL or HDL when the two groups were compared with each other or with their respective controls. Conclusions Increased lipid peroxidation occurring in vivo in diabetes is unlikely to be the result of increased susceptibility of lipoproteins to lipid peroxidation, but rather to increased generation of free radicals, to oxidation of lipids other than those present in serum lipoproteins or to decreases in antioxidant systems other than the fat‐soluble antioxidants present in lipoproteins.Diabet. Med. 16, 415–423 (1999)
Laboratory‐based calculation of coronary heart disease risk in a hospital diabetic clinic
Authors: Bayly G. R. , Bartlett W. A. , Davies P. H. , Husband D. , Haddon A. , Game F. L. , Jones A. F. 
Published: March 2003

Summary Aims To develop an estimation of risk of coronary heart disease (CHD) based on the Framingham equation for use in a diabetes clinic, given concerns about the accuracy of the Sheffield risk tables in this setting. Methods A computer program using the Framingham equation based on patients’ age, sex, systolic blood pressure, smoking history, presence of diabetes and left ventricular hypertrophy was applied to requests for lipid screening of patients attending the diabetes clinics of Birmingham Heartlands Hospital. The calculated risks for the population were compared with those estimated from the Sheffield tables. Results Of 1060 patients with diabetes mellitus, 215 (20%) had an annual CHD risk ≥ 3%, which is considered to be the threshold at which lipid‐lowering drugs are cost‐effective. Only 24 of these 215 patients (11%) were correctly identified by the Sheffield tables, which we conclude have an unacceptably low sensitivity in diabetes mellitus. Conclusions A laboratory‐based CHD risk calculation system is a practical alternative to the Sheffield system and may have a greater sensitivity in the diabetic clinic.
Enterovirus variants in the serum of children at the onset of Type 1 diabetes mellitus
Authors: Nairn C. , Galbraith D. N. , Taylor K. W. , Clements G. B. 
Published: March 2003

Summary Aims This study was designed to assess further the possible links between enterovirus infection and Type 1 diabetes mellitus (DM). Methods Sera from 110 children in the age range 0–15 years was obtained shortly after the diagnosis of Type 1 DM, in paediatric centres throughout the UK. They were tested for the presence of enteroviral sequences by the polymerase chain reaction (PCR) of the 5′ nontranslated region (5′ NTR). One hundred and eighty‐two controls tested were matched for age, geographical location and time of year. Results A significantly greater number of diabetic children (27% vs. 4.9%, P <0.005) had evidence of enteroviral RNA sequences. Proportionally, more younger children were enterovirus PCR positive, thus eight out of 20 children aged ≤2 years were enterovirus PCR positive. Sequence analysis showed that there was considerable variation in the sequences detected, although all appeared to be of the coxsackie/echovirus type. Conclusion This study re‐emphasizes that a link exists between enteroviral infection and the onset of Type 1 DM, particularly at a very early age, and suggests that these viruses are aetiologically important in diabetes in a significant proportion of children.
Analysis of a polycytosine tract and heteroplasmic length variation in the mitochondrial DNA D‐loop of patients with diabetes, MELAS syndrome and race‐matched controls
Authors: Gill‐Randall R. , Sherratt E. J. , Thomas A. W. , Gagg J. W. , Lee A. , Alcolado J. C. 
Published: March 2003

AbstractAim The T to C substitution at position 16189 nt of the human mitochondrial genome has been associated with the development of heteroplasmic length variation in the control region of mtDNA. Previous reports have suggested that this defect may be associated with the development of other pathogenic mtDNA mutations, including the diabetogenic A to G mutation in the tRNALEU(UUR). Recently the 16189 nt variant has also been associated with insulin resistance in British adult men. In order to investigate these associations further we studied 23 patients with the 3243 nt mutation, 150 patients with Type 2 diabetes and 149 non‐diabetic controls.Methods The region around 16189 nt was investigated by polymerase chain reaction‐restriction fragment length polymorphism analysis and automated sequencing.Results We find that the T to C substitution at 16189 nt is associated with heteroplasmic length variation only when the resultant polycytosine tract is not interrupted by a second mutation. There are no significant differences in the prevalence of the 16189 nt variant or heteroplasmic length variation between patients with the 3243 nt mutation, patients with Type 2 diabetes or race‐matched normal controls.Conclusions We conclude that these variants are likely to represent normal polymorphisms and that previously reported associations should be treated with caution unless they can be replicated in other populations.Diabet. Med. 18, 413–416 (2001)
Metabolic impact of a family history of Type 2 diabetes. Results from a European multicentre study (EGIR)
Authors: Vaag A. , Lehtovirta M. , Thye‐Rönn P. , Groop L. 
Published: March 2003

AbstractBackground Insulin resistance was found in some but not in all previous studies of non‐diabetic first degree relatives of Type 2 diabetic patients. Small study groups, ethnic differences and/or non‐optimal techniques may explain the conflicting results.Aim To study the impact of a family history of Type 2 diabetes on insulin action in a large group of non‐diabetic Europeans using the ‘gold standard’ euglycaemic hyperinsulinaemic clamp technique.Methods Non‐diabetic subjects (n = 235) with a positive family history of Type 2 diabetes (FH+) and 564 subjects with no family history of diabetes (FH−) were recruited from The European Group of Insulin Resistance (EGIR) database. This database includes measurements of insulin action using the insulin clamp technique (1 mU/kg per min) in normal glucose‐tolerant individuals from 20 different European centres. In a subset of subjects the measurements were performed in combination with indirect calorimetry (n = 80 vs. 213 with and without family history of Type 2 diabetes).Results The body mass index (BMI) was slightly higher in FH+ compared with FH− (26.7 ± 4.6 vs. 25.1 ± 4.7 kg/m2; P < 0.02). After correction for covariates according to differences between investigators and subject characteristics including BMI (multiple regression analysis), insulin‐stimulated glucose disposal was lower in FH+ compared with FH− (P < 0.00001). Insulin‐stimulated glucose oxidation was slightly increased in FH+ compared with FH−, and insulin‐stimulated non‐oxidative glucose metabolism was consequently markedly reduced in FH+ compared with FH− (P < 0.0005).Conclusion Insulin resistance is present in European non‐diabetic relatives of Type 2 diabetic patients. The insulin resistance is independent of degree of obesity and is restricted solely to the pathway of non‐oxidative glucose metabolism.Diabet. Med. 18, 533–540 (2001)
Insulin resistance as a major determinant of increased coronary heart disease risk in postmenopausal women with Type 2 diabetes mellitus
Authors: Stoney R. M. , O'Dea K. , Herbert K. E. , Dragicevic G. , Giles G. G. , Cumpston G. N. , Best J. D. 
Published: March 2003

AbstractAim  To investigate the risk factors associated with clinically defined coronary heart disease (CHD) in women with Type 2 diabetes mellitus (DM).Methods  CHD status was assessed via standard history and resting electrocardiogram in 41 postmenopausal diabetic and 41 age‐ and body mass index‐matched normoglycaemic women recruited from a community‐based cohort. The following parameters were assessed: body composition by dual energy X‐ray absorptiometry, blood pressure, metabolic and lipoprotein profile and haemostatic factors.Results  Diabetic women with CHD (n = 14) had greater insulin resistance, calculated by homeostasis model assessment (10.2 (7.0–14.8) vs. 6.5 (5.5–7.7), P = 0.010), and higher plasminogen activator inhibitor‐1 (PAI‐1) levels (45 (29–69) vs. 24 (19–32) ng/ml, P = 0.013), than those without CHD. They also had higher triglycerides (2.9 (2.2–3.8) vs. 2.1 (1.8–2.4) mmol/l, P = 0.016) and a trend towards reduced low‐density lipoprotein particle size (25.5 ± 0.6 vs. 25.8 ± 0.5 nm, P = 0.097). In a logistic regression model, insulin resistance was a significant independent predictor of CHD status (odds ratio = 1.33, 95% confidence interval = 1.06–1.68, P = 0.015). In contrast, in normoglycaemic women the major risk factors for CHD were elevated cholesterol, apolipoprotein(a), apolipoprotein B and systolic blood pressure (P = 0.018, P = 0.016, P = 0.006 and P = 0.049, respectively).Conclusions  Increased insulin resistance in association with elevated PAI‐1 and dyslipidaemia appears to underpin the increased risk of CHD in women with Type 2 DM. Therapeutic approaches that increase insulin sensitivity may serve to reduce CHD risk in this vulnerable group.Diabet. Med. 18, 476–482 (2001)