bluuebunny/crossref_metadata_2025_split huggingface dataset:
Carcinoma of donor origin after liver‐intestine transplantation in a child
Authors: Neto Joao Seda , Macedo Camila , Jaffe Ronald , Mazariegos George V. , Sindhi Rakesh , Bond Geoffrey J. , Abu‐Elmagd Kareem , Reyes Jorge 
Published: March 2005

Abstract:  Tumor‐related complications after intestinal transplantation in children have been principally EBV driven post‐transplant disorders. We describe the clinical course of a child, with a diagnosis of microvillus inclusion disease who received a liver and intestine allograft at the age of 9 months. His postoperative course was significant for multiple episodes of acute intestinal allograft rejection and eventually the development of post‐transplant lymphoproliferative disorder (PTLD), which resolved. At 8 yr post‐transplant he presented with masses in the intestine allograft mesentery and in the right lobe of the allograft liver, biopsy of which revealed a relatively undifferentiated tumor, suggestive of a carcinoma. In situ hybridization for X and Y chromosomes, revealed his tumor to be of donor origin. Treatment included debulking of the mesenteric mass with segmental enterectomy of the intestinal allograft, and stopping his immunosuppression for a period of 4 months; this resulted in complete resolution of his malignancy. Immunosuppression with tacrolimus and steroids was restarted because of intestinal allograft rejection; he died suddenly of unknown causes at 17 months post‐diagnosis of carcinoma.The severely immunosuppressed state produced in this patient allowed for the development of an unusual donor derived carcinoma, which resolved spontaneously with withdrawal of immunosuppression. The mechanism of such regression of tumor may be related to restitution of immunologic competence, but is yet to be determined.
Improved long‐term allograft function in pediatric renal transplantation with mycophenolate mofetil
Authors: Ferraris Jorge R. , Ghezzi Lidia F. R. , Vallejo Graciela , Piantanida Juan J. , Araujo Jose L. , Sojo Ernesto T. 
Published: March 2005

Abstract:  MMF has been shown to decrease the incidence of acute rejection in children and adults at 1 and 3 yr. Other beneficial effects of MMF have been more difficult to demonstrate. Our open‐labeled study presents a 5‐yr data for patients and graft survival, allograft function, and growth in MMF‐treated patients. The trial included 29 patients who were treated with MMF in combination with cyclosporine and methylprednisone. Patients were compared with a preceding group of 29 patients treated with AZA instead of MMF. Patient and graft survival rate 5 yr after transplantation were 97 and 90% in the MMF group vs. 93 and 83% in the AZA group (p: NS). Acute rejection was 20.6% in the MMF group vs. 58.6% in the AZA group (p < 0.01). Chronic rejection was 10.3% in the MMF group and 25% in the AZA group (p: NS). The changes in the creatinine clearance from baseline to 5 yr (Δ) were different between groups (−6.0 ± 5.1 mL/min/1.73 m2 in the MMF group vs. −22.2 ± 7.6 mL/min/1.73 m2 in the AZA group, p < 0.05). Also, the slope of 1/Scr showed a significant lower incidence of worsening renal function after the second year of renal transplantation (p < 0.0001) in the MMF group compared with the AZA group. Δ Height SDS in prepubertal patients was 0.3 ± 0.4 SDS in the MMF group vs. −0.8 ± 0.2 SDS in the AZA group (p < 0.05).This study shows that long‐term MMF therapy has resulted in a decrease in acute rejection and was associated with a protection against renal function deterioration. The use of MMF enables a reduction in the dose of steroids and leads to a linear growth improvement of children after renal transplantation.
Tumour necrosis factor receptors (TNFRs) in Type 2 diabetes. Analysis of soluble plasma fractions and genetic variations of TNFR2 gene in a case‐control study
Authors: Vendrell J. , Broch M. , Fernandez‐Real J. M. , Gutiérrez C. , Simón I. , Megia A. , Gallart L. , Ricart W. , Richart C. 
Published: March 2005

AbstractAims  We have studied the relationships between soluble fractions of tumour necrosis factor receptors (sTNFR1 and sTNFR2) in Type 2 diabetes (DM2) and its chronic microvascular complications. Likewise, we have analysed the genetic susceptibility of 196T > G exon6/CA‐repeat intron 4 mutations in the TNFR2 gene in this population.Methods  A case‐control study was conducted to examine the role of sTNFRs in 345 DM2 patients and 173 healthy subjects. The mutations were studied in all healthy subjects and in a subset of 232 patients.Results  sTNFRs levels were similar in healthy and DM2 patients. A positive correlation between age and both sTNFRs was observed in healthy subjects. In DM2 patients, sTNFR1 showed a positive correlation with age, systolic blood pressure and leptin levels (r = 0.53, P < 0.0001; r = 0.28, P = 0.005; r = 0.46, P < 0.0001, respectively) and sTNFR2 was positively correlated with age, triglycerides and leptin levels (r = 0.34, P < 0.0001; r = 0.21, P < 0.0001; r = 0.28, P = 0.002, respectively). Patients with micro‐ or macroalbuminuria showed higher plasma levels of sTNFR1 and sTNFR2 than normoalbuminuric patients, after adjusting for confounding variables (B = 0.85, P = 0.022, 95% CI: 0.12–1.58 for sTNFR1 and B = 1.50, P < 0.001, 95% CI: 0.67–2.33 for sTNFR2). In DM2 patients, TT‐exon 6 homozygous showed lower levels of sTNFR1 [2,4 (1.1) vs. 3.4 (1.2) ng/ml], and the CA273‐allele tracked with elevated plasma HDL‐cholesterol [1.8 (0.7), 1.4 (0.3) and 1.3 (0.3) mm, for CA273/273, CA273/– and CA–/–, respectively]. No association was seen with other analysed variables.Conclusions  Our findings suggest that chronic TNF activation may have some pathogenic role in diabetic nephropathy in DM2 patients. Genetic variations in exon 6/intron 4 of the TNFR2 gene do not predispose to a major risk for DM2 or its microvascular complications
A long‐term comparison of pioglitazone and gliclazide in patients with Type 2 diabetes mellitus: a randomized, double‐blind, parallel‐group comparison trial
Authors: Charbonnel B. H. , Matthews D. R. , Schernthaner G. , Hanefeld M. , Brunetti P. ,   on behalf of the QUARTET Study Group
Published: March 2005

AbstractAims  This study compared the effects of pioglitazone and gliclazide on metabolic control in drug‐naïve patients with Type 2 diabetes mellitus.Methods  A total of 1270 patients with Type 2 diabetes were randomized in a parallel‐group, double‐dummy, double‐blind study. Patients with poorly controlled Type 2 diabetes (HbA1c 7.5–11%), despite dietary advice, received either pioglitazone up to 45 mg once daily or gliclazide up to 160 mg two times daily. Primary efficacy endpoint was change in HbA1c from baseline to the end of the study. Secondary efficacy endpoints included change in fasting plasma glucose, fasting plasma insulin and plasma lipids. At selected centres, oral glucose tolerance tests were performed and C‐peptide and pro‐insulin levels were measured.Results  Mean HbA1c values decreased by the same amount in the two treatment groups from baseline to week 52 [pioglitazone: −1.4%; gliclazide: −1.4%; (90% CI: −0.18 to 0.02)]. A significantly greater mean reduction in fasting plasma glucose was observed in the pioglitazone group (2.4 mmol/l) than in the gliclazide group [2.0 mmol/l; treatment difference −0.4 mmol/l in favour of pioglitazone; P = 0.002; (95% CI: −0.7 to −0.1)]. Improvements in high‐density lipoprotein cholesterol (HDL‐C) and total cholesterol/HDL‐C were greater with pioglitazone than with gliclazide (P < 0.001). The frequencies of adverse events were comparable between the two treatment groups, but more hypoglycaemic events were reported for gliclazide, whereas twice as many patients reported oedema with pioglitazone than with gliclazide.Conclusions  Pioglitazone monotherapy was equivalent to gliclazide in reducing HbA1c, with specific differences between treatments in terms of mechanism of action, plasma lipids and adverse events.
Criteria for previously undiagnosed diabetes and risk of mortality: 15‐year follow‐up of the Edinburgh Artery Study cohort
Authors: Wild S. H. , Smith F. B. , Lee A. J. , Fowkes F. G. R. 
Published: March 2005

AbstractAims  To compare risk of all‐cause and cardiovascular mortality associated with different criteria for undiagnosed diabetes and glucose tolerance.Methods  A population‐based cohort of 758 men and 738 women of 55–74 years of age who had an oral glucose tolerance test or known diabetes at baseline were followed up until death or for 15 years. Mortality outcomes were compared by baseline diabetes status using people with normal glucose tolerance (i.e. those without diabetes, impaired fasting glucose or impaired glucose tolerance) as the reference group.Results  Prevalence of undiagnosed diabetes using World Health Organization (WHO) criteria (fasting glucose of ≥ 7.0 mmol/l and/or a 2‐h post‐challenge glucose of ≥ 11.1 mmol/l) was 6.6%, of which 81% was associated with fasting glucose ≥ 7.0 mmol/l and 19% was associated with isolated post‐challenge hyperglycaemia. Hazard ratios (95% CI) for all‐cause mortality adjusted for age and sex were 1.51 (1.09–2.08) for new diabetes by the American Diabetes Association (ADA) criterion (fasting glucose of ≥ 7.0 mmol/l regardless of post‐challenge glucose), 1.60 (1.20–2.13) for new diabetes by WHO criteria and 1.98 (1.14–3.44) for isolated post‐challenge hyperglycaemia. Hazard ratios (95% CI) for cardiovascular mortality adjusted for age and sex were 1.89 (1.17–3.00), 1.73 (1.12–2.66) and 1.08 (0.34–3.40) for new diabetes by ADA and WHO criteria and for isolated post‐challenge hyperglycaemia, respectively.Conclusions  Undiagnosed diabetes was associated with increased risk of all‐cause mortality by any criteria but significantly increased cardiovascular disease mortality was only associated with diabetes diagnosed using the fasting glucose criterion. Mortality risks were similar in this population using either ADA or WHO criteria for diagnosis of diabetes.
Optimization of basal insulin delivery in Type 1 diabetes: a retrospective study on the use of continuous subcutaneous insulin infusion and insulin glargine
Authors: Fahlén M. , Eliasson B. , Odén A. 
Published: March 2005

AbstractAims  To compare the effects on glycaemic control after using continuous subcutaneous insulin infusion (CSII) or insulin glargine.Methods  Data were obtained from 17 diabetes outpatient clinics in Sweden, employing the same diabetes data management system. Type 1 diabetic patients using multiple dose injections were included prior to starting on either CSII (n = 563) or glargine (n = 513). The median duration of therapy was 25 months for CSII and 6 months for glargine. The comparison between the treatment modalities was carried out by multiple regression analysis and logistic regression analysis in an attempt at reducing the influence of confounding factors.Results  The mean HbA1c decrease was 0.59 ± 1.19% for CSII and 0.20 ± 1.07% for glargine (P < 0.001, when assessed by logistic regression). An additional 0.1% lower HbA1c would be expected if glargine had been optimized with basal insulin 40–60% of the daily dose. The more pronounced effect of CSII was achieved with a lower daily dosage of insulin. In a multiple regression analysis with a change of HbA1c as the dependent variable, the following variables were significant: choice of treatment (P < 0.001), HbA1c prior to treatment (P < 0.001) and BMI prior to treatment (P < 0.01).Conclusion  Both regimes improved metabolic control, but CSII resulted in significantly higher reduction in HbA1c than after insulin glargine treatment, particularly in those individuals who had higher levels of HbA1c at baseline.
Is the relationship between adherence behaviours and glycaemic control bi‐directional at adolescence? A longitudinal cohort study
Authors: Du Pasquier‐Fediaevsky L. , Chwalow A. J. ,   the PEDIAB Collaborative Group, Tubiana‐Rufi N. 
Published: March 2005

AbstractAim  To analyse the change in adherence to diabetes treatment and its association with metabolic control from childhood to adolescence. The Tanner pubertal staging model was selected as a marker of developmental maturity.Methods  In a multicentre, longitudinal cohort study, 142 children with Type 1 diabetes completed a scale that assessed adherence to treatment and a test of diabetes knowledge at the beginning of the study (T0) and four years later (T4). HbA1c and clinical data were collected at T0 and at T4.Results  From T0 to T4, the mean HbA1c increased from 8.2 ± 1.6 to 9.1 ± 1.4% (P < 0.001). Among patients at pubertal stages 1–4, adherence did not decline from T0 to T4, whereas the HbA1c level increased and a positive correlation between adherence and the knowledge score was noted (r = 0.32; P < 0.02). Among adolescents at pubertal stage 5, the level of adherence decreased (P < 0.01) from T0 to T4 and the HbA1c level increased despite an increase in the knowledge score (P < 0.001), a negative correlation between HbA1c and adherence was found (r = −0.37; P = 0.001) and adherence at T4 significantly added to the prediction of HbA1c at T4.Conclusions  In this longitudinal study, an initial worsening of glycaemic control as a result of puberty preceded worsening of adherence behaviours. Low levels of adherence become predictive of HbA1c degradation among pubertal stage 5 adolescents. These results suggest a potential bi‐directional relationship between glycaemic control and adherence.
Effect of maternal diabetes on phosphorylation of insulin‐like growth factor binding protein‐1 in cord serum
Authors: Loukovaara M. , Leinonen P. , Teramo K. , Nurminen E. , Andersson S. , Rutanen E.‐M. 
Published: March 2005

AbstractAims  The insulin‐like growth factor (IGF) system is considered important in the regulation of fetal growth. Binding of IGFs to specific binding proteins (IGFBPs) modifies their actions. In fetal blood, IGFBP‐1 is the primary IGF binding protein whose phosphorylation generates proteins with different affinities for IGF‐I. We studied cord serum IGFBP‐1 phosphoisoform profiles in normal pregnancies and in diabetic pregnancies, which are frequently complicated by macrosomia.Research design and methods  Cord serum IGFBP‐1 phosphoisoform concentrations were measured at birth by two immunoenzymometric assays in 67 pregnancies complicated by Type 1 diabetes, in 28 pregnancies complicated by insulin‐treated gestational diabetes, and in 62 normal pregnancies.Results  Cord serum highly phosphorylated IGFBP‐1 (hpIGFBP‐1) concentrations were lower in pregnancies complicated by Type 1 diabetes (204 ± 36 µg/l, P = 0.032) and in pregnancies complicated by gestational diabetes (170 ± 28 µg/l, P = 0.031) than in controls (316 ± 34 µg/l). Cord serum lesser phosphorylated IGFBP‐1 (lpIGFBP‐1) concentrations were similar in diabetic and normal pregnancies (P = 0.692 between groups by analysis of variance). Relative birth weight correlated negatively with cord serum hpIGFBP‐1 and lpIGFBP‐1 in diabetic pregnancies, and with cord serum lpIGFBP‐1 in normal pregnancies.Conclusions  Maternal diabetes is associated with suppressed hpIGFBP‐1 but unaltered lpIGFBP‐1 concentrations in cord serum, suggesting that IGFBP‐1 phosphoisoforms are differentially regulated in the fetus. Because hpIGFBP‐1 has a higher affinity for IGF‐I than does lpIGFBP‐1, diabetes‐related changes in fetal IGFBP‐1 phosphorylation may increase IGF‐I bioavailability and, consequently, stimulate fetal growth. This may partly explain the increased occurrence of macrosomia in diabetic pregnancies.
Birthweight and other pregnancy outcomes in a cohort of women with pre‐gestational insulin‐treated diabetes mellitus, Scotland, 1979–95
Authors: Silva I. dos Santos , Higgins C. , Swerdlow A. J. , Laing S. P. , Slater S. D. , Pearson D. W. M. , Morris A. D. 
Published: March 2005

AbstractAims  To assess pregnancy outcomes, in particular birthweight, in a large population‐based cohort of women in Scotland with pre‐gestational insulin‐treated diabetes mellitus.Methods  Data about diabetes from the Diabetes UK cohort were linked to data on births from the Scottish Hospital In‐Patient Record System. This identified 1112 eligible singleton deliveries during 1979–95 to 706 insulin‐treated women.Results  One thousand and eighty‐four (97.5%) deliveries resulted in a live‐born infant and 28 (2.5%) in a stillbirth. There were 13 (1.2%) neonatal deaths. The mean birthweight of the live‐born infants was 3421 g, 1.06 standard deviations greater than that of infants in the Scottish general population after correcting for sex and gestational age. Forty‐three per cent of live‐born babies in the study were large (> Scottish 90th percentile) and 4% small (< 10th percentile) for their sex and gestational age. Macrosomia, defined as birthweight ≥ 4000 g, occurred in 23% live‐born babies and its prevalence was significantly inversely related to duration of maternal diabetes. However, the mean birthweight of infants born to mothers with diabetes for 20 or more years was still 0.90 standard deviations greater than in the general population. Prevalence of macrosomia increased with increasing number of previous pregnancies, but was not associated with maternal height or smoking habits. Stillbirth and neonatal death rates were, respectively, 4.7 (95% confidence interval = 3.3, 6.8) and 2.4 (1.4, 4.1), times higher than those in the general population.Conclusions  The frequency of adverse pregnancy outcomes in women with pre‐existing insulin‐treated diabetes was much higher than in the Scottish general population, and changed little during the study period. A detailed quantification of the independent effect of duration of mother's diabetes on birthweight revealed a continuous inverse correlation between these two variables.
Autoantibodies to GAD and IA‐2 in Saudi Arabian diabetic patients
Authors: Damanhouri L. H. , Dromey J. A. , Christie M. R. , Nasrat H. A. , Ardawi M. S. M. , Robins R. A. , Todd I. 
Published: March 2005

AbstractAims  To determine the prevalence of autoantibodies in sera of Saudi diabetic patients including Type 1 and Type 2 diabetes mellitus (DM) and gestational diabetes mellitus (GDM) living in Jeddah, Saudi Arabia. Apart from data on the prevalence of islet‐cell antibodies in patients in Ryhadh (Al‐Attas et al. Freqency of islet cell antibodies in adult newly diagnosed diabetic patients. Ann Saudi Med 1990; 10: 369–373) immunological markers of autoimmune diabetes have not been explored in Saudi Arabians.Methods  Autoantibodies to GAD65 (GADA) and IA‐2 (IA‐2A) were determined using radio‐immunoprecipitation assays.Results  In Type 1 DM patients, 54% were GADA+ and 27% were IA‐2A+. A greater negative effect of disease duration was noted for IA‐2A than for GADA positivity. Autoantibodies were more prevalent with younger age of onset. GADA were slightly more common in female Type 1 DM patients. In Type 2 DM, 8/99 patients were GADA+, and three of these patients with shorter disease duration were also IA‐2A+. GADA, and particularly IA‐2A, were associated with a younger age of onset of Type 2 DM and all the autoantibody‐positive Type 2 DM patients were insulin‐treated. GADA were detected in 2.2% of GDM patients, but none of these patients possessed IA‐2A.Conclusions  The prevalence and associations of autoantibodies in Saudi diabetic patients are very similar to those reported for diabetic patients in other ethnic groups.
Preserved insulin response to tolbutamide in hepatocyte nuclear factor‐1α mutation carriers
Authors: Sagen J. V. , Pearson E. R. , Johansen A. , Spyer G. , Søvik O. , Pedersen O. , Njølstad P. R. , Hattersley A. T. , Hansen T. 
Published: March 2005

AbstractAims  Diabetic subjects with mutations in the gene encoding hepatocyte nuclear factor (HNF)‐1α (MODY3) are prone to develop hypoglycaemia at low doses of glibenclamide, interpreted as sulphonylurea hypersensitivity. The present study was undertaken to compare the plasma insulin responses to glucose and tolbutamide in HNF‐1α mutation carriers with those of healthy control subjects.Methods  Seven mutation carriers; three normoglycaemic, two with impaired glucose tolerance, and two with newly detected diabetes, underwent an oral glucose tolerance test and a tolbutamide‐modified intravenous glucose tolerance test with measurements of plasma insulin. Twenty‐two healthy subjects served as controls.Results  The plasma insulin response to intravenous glucose was reduced in the HNF‐1α mutation carriers compared to the control subjects, with an area under the curve (median (interquartile range)) of 812 min pmol/l (421, 1647) and 1933 min pmol/l (1521, 2908), respectively (P = 0.03). In striking contrast, the plasma insulin response to tolbutamide was preserved, with an area under the curve of 2109 min pmol/l (1126, 3172) and 2250 min pmol/l (1614, 3276) in the mutation carriers and control subjects, respectively.Conclusions  HNF‐1α mutation carriers are characterized by preserved tolbutamide‐induced insulin secretion. Compared to healthy subjects, our MODY3 individuals did not show any increased serum insulin response to tolbutamide, suggesting that HNF‐1α mutation carriers are not characterized by sulphonylurea hypersensitivity.
School attendance in children with Type 1 diabetes
Authors: Glaab L. A. , Brown R. , Daneman D. 
Published: March 2005

AbstractAims  To determine whether children with Type 1 diabetes mellitus (DM) miss more school than their non‐DM siblings and peers and to identify factors associated with school absenteeism in children with DM.Methods  School absenteeism data for the 2000–01 school year were obtained for 78 children with DM, 38 non‐DM siblings and 118 269 age‐matched peers in Toronto, Ontario. Questionnaires and hospital records were utilized to evaluate child‐, family‐ and diabetes‐related factors associated with school absenteeism in children with DM.Results  Children with DM missed only slightly, albeit significantly more school than both their non‐DM siblings (mean ±sd: 10.9 ± 8.9 vs. 8.1 ± 8.1 days, P < 0.001) and peers (median: 8.8 vs. 5.5 days, P = 0.0005). A multiple regression analysis indicated that school absenteeism in children with DM was associated with their parents’ attitudes towards school attendance (P = 0.002), poorer metabolic control (P = 0.006), shorter disease duration (P = 0.006) and a lack of aggressive behaviour (P = 0.02).Conclusions  With current management strategies, near normal school attendance is a reasonable goal for all children with DM and should be strongly encouraged by parents, educators and health care professionals.