bluuebunny/crossref_metadata_2025_split huggingface dataset:
Detecting silent coronary stenoses and stratifying cardiac risk in patients with diabetes: ECG stress test or exercise myocardial scintigraphy?
Authors: Cosson E. , Paycha F. , Paries J. , Cattan S. , Ramadan A. , Meddah D. , Attali J‐R. , Valensi P. 
Published: March 2004

AbstractAims  To determine whether performing a myocardial scintigraphy immediately after a maximal electrocardiogram (ECG) stress test is effective in detecting silent coronary stenoses and predicting cardiovascular events.Methods  Asymptomatic patients (n = 262) aged 57.6 ± 8.8 years, with diabetes for 12.0 years (5–39) [median (range)] and no history of a cardiac event, underwent a maximal ECG stress test followed by a myocardial scintigraphy. The patients with an abnormal ECG stress test or abnormal imaging underwent a coronary angiography. Cardiac events were assessed in 250 (95.4%) patients followed for 37.8 months (3–101).Results  The ECG stress test was abnormal in 54 patients. Among them, 18 had coronary stenoses and seven had a cardiac event. Despite a normal ECG stress test, the myocardial scintigraphy was abnormal in 42 additional patients, including 16 patients with coronary stenoses. Four of these 42 patients experienced a cardiac event. Follow‐up showed a poor prognosis in subjects who were abnormal on the two tests. Univariate predictors of the 15 cardiac events were the ECG stress test [odds ratio (OR) 3.9, 95% confidence interval (CI) 1.3, 11.4, P = 0.008], myocardial scintigraphy (OR 3.8, 95% CI 1.3, 11.0, P = 0.009), coronary stenoses (OR 26.6, 95% CI 7.6, 90.7, P < 0.001), and peripheral or carotid occlusive arterial disease (OR 9.5, 95% CI 2.1, 42.5, P < 0.001).Conclusions  In the asymptomatic patients with diabetes, combining a myocardial scintigraphy with a maximal ECG stress test is effective in detecting more patients with coronary stenoses and predicting cardiovascular events. However, the ECG stress test has a good negative predictive value for cardiac events (97%), is cheaper, and should therefore be proposed first.
The associations of body mass index, C‐peptide and metabolic status in Chinese Type 2 diabetic patients
Authors: Chan W. B. , Tong P. C. Y. , Chow C. C. , So W. Y. , Ng M. C. Y. , Ma R. C. W. , Osaki R. , Cockram C. S. , Chan J. C. N. 
Published: March 2004

AbstractBackground  Chinese Type 2 diabetic subjects are generally less obese than their Caucasian counterparts. We hypothesized that lean and obese Chinese Type 2 diabetic subjects have different metabolic and insulin secretory profiles. We compared the clinical features, C peptide and metabolic status between lean/normal weight and obese diabetic subjects.Study design  We conducted a cross‐sectional study on 521 consecutive diabetic subjects newly referred to a Diabetes Clinic in 1996. The subjects were categorized into underweight (< 18.5 kg/m2), normal weight (18.5–23 kg/m2) and overweight (≥ 23 kg/m2) according to the re‐defined WHO criterion for obesity in Asia Pacific Region. Metabolic and anthropometric parameters were compared between groups with different levels of obesity.Results  In this cohort, 5.8, 30.6 and 63.7% of subjects were underweight, normal weight and overweight, respectively, using the ‘Asian’ criteria. Of these 521 subjects, 20% had fasting C‐peptide less than 0.2 nmol/l, suggesting insulin deficiency. Fasting C‐peptide showed linear increasing trend (P < 0.001) while HbA1c showed decreasing trend (P = 0.001) with BMI after adjustment for duration of disease. There were more subjects in the underweight group who were treated with insulin (41.3% vs. 13.9 and 8.2%, P < 0.001). Although homeostasis model assessment was similar amongst the three groups, systolic (P = 0.006) and diastolic blood pressure (P < 0.001) and triglyceride (P < 0.001) showed increasing, while HDL‐C (P < 0.001) showed decreasing, trends across different BMI groups. The underweight patients had the lowest C‐peptide and highest HbA1c while overweight patients had the highest C‐peptide, blood pressure, triglyceride but lowest HbA1c levels.Conclusion  In Chinese Type 2 diabetic patients, lean subjects had predominant insulin deficiency and obese subjects had features of metabolic syndrome. Clinicians should have low threshold to initiate insulin therapy in lean Type 2 diabetic patients with suboptimal glycaemic control. In obese diabetic patients, aggressive control of multiple cardiovascular risks is of particular importance.
Prevalence and risk factors for diabetes in Ho Chi Minh City, Vietnam
Authors: Duc Son L. E. N. T. , Kusama K. , Hung N. T. K. , Loan T. T. H. , Van Chuyen N. , Kunii D. , Sakai T. , Yamamoto S. 
Published: March 2004

AbstractAims  To determine the prevalence of diabetes and associated risk factors in Ho Chi Minh City, Vietnam.Methods  A total of 2932 participants aged 15 and above in Ho Chi Minh City were screened for diabetes in a cross‐sectional study. The study was conducted from March–May 2001. Demographic, occupation, anthropometry and blood pressure were recorded. Blood glucose was calculated on fasting capillary and venous blood. The classification of diabetes and impaired fasting glucose (IFG) was carried out according to WHO and American Diabetes Association criteria.Results  The crude prevalence of diabetes and IFG were 6.6 and 3.2%, respectively. After age, sex‐adjustment to the Vietnam population census, the prevalence was 3.8 and 2.5%, respectively; approximately 40% of cases were found to be newly diagnosed diabetes. The crude prevalence of diabetes in the urban area was approximately 2.8 times higher than that recorded in the 1993 study (6.9 vs. 2.5%, respectively). In this study, there was a positive association between diabetes and sex, age, overweight, waist hip ratio (WHR), and having a history of delivering large for gestational age child; there was a negative association between diabetes and physical activity and occupation.Conclusions  This study found that the age, sex‐adjusted prevalence of diabetes and IFG in Ho Chi Minh City were 3.8 and 2.5%, respectively, a rapid increase in the recent decade. Our study also indicates that ageing, a high WHR level, overweight and a sedentary lifestyle may be important determinants of the increased prevalence of diabetes during this transition period in Vietnam.
Impaired fasting glycaemia resembles impaired glucose tolerance with regard to cardiovascular risk factors: population‐based, cross‐sectional study of risk factors for cardiovascular disease
Authors: Heldgaard P. E. , Olivarius N. de. F. , Hindsberger C. , Henriksen J. E. 
Published: March 2004

AbstractAims  To compare subjects with impaired glucose tolerance and impaired fasting glucose in relation to risk factors for developing cardiovascular disease.Methods  A total of 1374 patients (678 female, 696 male) listed with a general practice clinic in Denmark were given an oral glucose tolerance test, a physical examination, and a self‐administered questionnaire. Risk factors for cardiovascular disease were assessed for 90 participants (48 female, 42 male) with impaired glucose tolerance (including 12 subjects (1 female and 11 male), who also fulfilled criteria for impaired fasting glycaemia) and 51 subjects (20 female, 31 male) with impaired fasting glycaemia (World Health Organization 1999 criteria).Results  There were no statistical differences with regard to known risk factors for cardiovascular disease between participants with isolated impaired fasting glycaemia and those with impaired glucose tolerance.Conclusions  We found noticeable similarities in the cardiovascular risk factor profile in subjects with impaired fasting glycaemia and in subjects with impaired glucose tolerance in our population. When planning screening initiatives, it seems relevant to take into account people with impaired fasting glycaemia as well as those with impaired glucose tolerance.
Unreliable estimation of HbA1c due to the presence of Camperdown haemoglobin [β 104 (G6) Arg → Ser]
Authors: Castelli R. , Tempesta A. , Bianchi A. , Porro T. , Ivaldi G. , Cappellini M. D. 
Published: March 2004

AbstractAims  To suggest the possible unreliability of HbA1c determination in presence of haemoglobin variants during routine metabolic evaluation.Methods  We present a case of Camperdown haemoglobin, accidentally detected in a middle‐aged Italian man during routine metabolic evaluation for newly diagnosed diabetes. The haemoglobin variant has been identified by exchange high performance liquid chromatography (CE‐HPLC) (VARIANT™ HbA1c Program, Bio‐Rad Laboratories, Hercules, CA, USA), and characterized at molecular level by direct sequencing.Results  A 56‐year‐old male of Northern Italian origin, presented to our centre for a Type 2 diabetes mellitus of recent diagnosis. HbA1c determination was routinely determinated. The patient's chromatogram showed an inappropriate peak of 38.5% in the HbA1c position suggestive for the presence of abnormal haemoglobin. Further evaluation identified an abnormal haemoglobin peak even higher (49.5%) eluting at 1.34 minutes in P2‐window. Molecular characterization of the mutation showed a nucleotide replacement, AGG → AGC at codon 104, causing the amino acid replacement Arg → Ser at position 104 (G6) that give rise to Hb Camperdown.Conclusions  Haemoglobinopathies can lead to inaccurate glycated haemoglobin level determination. In patients carrying haemoglobin variants, the different methods for determinations of glycated haemoglobin could result in different errors, showing either higher or lower values than expected.
Severe hypertriglyceridaemia in diabetic ketoacidosis: clinical and genetic study
Authors: Karagianni C. , Stabouli S. , Roumeliotou K. , Traeger‐Synodinos J. , Kavazarakis E. , Gourgiotis D. , Lambrou J. , Kanavakis E. 
Published: March 2004

AbstractThe lipoprotein lipase coding gene sequence was analysed on a 10‐year‐old girl with new‐onset Type 1 diabetes mellitus (DM), ketoacidosis and severe hypertriglyceridaemia (TG > 112.9 mmol/l), revealing that the patient was a compound heterozygote for two mutations, D9N in exon 2 and S447X in exon 9. Although these two mutations usually do not considerably impair lipolytic enzyme activity, the combination of both in this patient may play a role in the development of severe hypertriglyceridaemia.
Hypoadiponectinaemia in South Asian women during pregnancy: evidence of ethnic variation in adiponectin concentration
Authors: Retnakaran R. , Hanley A. J. G. , Raif N. , Connelly P. W. , Sermer M. , Zinman B. 
Published: March 2004

AbstractAims  People of South Asian descent face an increased risk of Type 2 diabetes mellitus (DM) and coronary artery disease (CAD) compared with other ethnic groups. One candidate factor underlying this risk may be adiponectin, as circulating levels of this adipocyte‐derived protein are reduced in both Type 2 DM and CAD. In a recent study, we assessed the relationship between adiponectin and gestational diabetes (GDM), a potential model of early events in the natural history of Type 2 DM. Here, we report the impact of ethnicity on plasma adiponectin concentration in that study.Methods  A cross‐sectional study was performed in 180 women undergoing oral glucose tolerance testing in late second or early third trimester to investigate the relationship between adiponectin and glucose tolerance in pregnancy. Based on self‐reported ethnicity, participants were stratified into three groups: (i) Caucasian (n = 116), (ii) South Asian (n = 31), and (iii) Asian (n = 28).Results  Median adiponectin concentration was much lower in the South Asian group (9.7 µg/ml) than in Caucasians (15.8 µg/ml) or Asians (16.1 µg/ml) (overall P < 0.0001). With adjustment for age, prepregnancy body mass index, weight gain in pregnancy, previous history of GDM, family history of DM, fasting insulin and glucose intolerance, mean adiponectin remained significantly lower among South Asians compared with either Caucasians (P < 0.0001) or Asians (P = 0.0034).Conclusions  Women of South Asian descent exhibit significantly reduced plasma concentrations of adiponectin in pregnancy compared with Caucasian and Asian counterparts. This observation raises the possibility of hypoadiponectinaemia as a potential factor contributing to the increased risk of diabetes and cardiovascular disease in South Asians.
Accelerating aging by mouse reverse genetics: a rational approach to understanding longevity
Authors: Hasty Paul , Vijg Jan 
Published: March 2004

SummaryInvestigating the molecular basis of aging has been difficult, primarily owing to the pleiotropic and segmental nature of the aging phenotype. There are many often interacting symptoms of aging, some of which are obvious and appear to be common to every aged individual, whereas others affect only a subset of the elderly population. Although at first sight this would suggest multiple molecular mechanisms of aging, there now appears to be almost universal consensus that aging is ultimately the result of the accumulation of somatic damage in cellular macromolecules, with reactive oxygen species likely to be the main damage‐inducing agent. What remains significant is unravelling how such damage can give rise to the large variety of aging symptoms and how these can be controlled. Although humans, with over a century of clinical observations, remain the obvious target of study, the mouse, with a relatively short lifespan, easy genetic accessibility and close relatedness to humans, is the tool par excellence to model aging‐related phenotypes and test strategies of intervention. Here we present the argument that mouse models with engineered defects in genome maintenance systems are especially important because they often exhibit a premature appearance of aging symptoms. Confirming studies on human segmental progeroid syndromes, most of which are based on heritable mutations in genes involved in genome maintenance, the results thus far obtained with mouse models strongly suggest that lifespan and onset of aging are directly related to the quality of DNA metabolism. This may be in keeping with the recent discovery of a possible ‘universal survival’ pathway that improves antioxidant defence and genome maintenance and simultaneously extends lifespan in the mouse and several invertebrate species.
Lung fractional moving blood volume in normally grown and growth restricted foetuses
Authors: Hernandez‐Andrade Edgar , Thuring‐Jönsson Ann , Jansson Tomas , Lingman Göran , Maršàl Karel 
Published: March 2004

SummaryObjective:  To examine foetal lung blood perfusion using power Doppler ultrasound (PDU) and to compare fractional moving blood volume (FMBV) and mean pixel intensity (MPI) estimations in the lungs of normally grown (NG) foetuses and foetuses with intrauterine growth restriction (IUGR) and also to correlate foetal lung FMBV and MPI with respiratory complications after birth.Methods:  Lungs of 47 NG and 25 IUGR foetuses after 32 weeks of gestation were examined with PDU. FMBV and MPI were estimated in a defined region in the posterior part of the foetal lung closest to maternal abdominal wall. FMBV and MPI were correlated to foetal weight deviation and gestational age. Perinatal outcome and respiratory complications after birth were recorded in both groups.Results:  There were significantly lower FMBV and MPI values in IUGR than in NG foetuses. The overall variation was lower for FMBV than for MPI. There was a slightly higher correlation between FMBV and foetal weight deviation [r = 0·33, 95% confidence intervals (CI) 0·11–0·52] than between MPI and foetal weight deviation (r = 0·26, 95% CI 0·03–0·46). There was no significant correlation between FMBV or MPI and gestational age. No differences between the groups were found in the rate of respiratory complications, and they were not correlated either to the FMBV or MPI.Conclusion:  FMBV and MPI, estimated from the PDU signals of foetal lung circulation, showed lower values in third‐trimester pregnancies complicated by IUGR. The frequency of neonatal respiratory complications was not increased in cases with low pulmonary FMBV and MPI values.
The synthesis rate of albumin decreases during laparoscopic surgery
Authors: Barle Hans , Hållström Lars , Essèn Pia , Thörne Anders , McNurlan Margaret A. , Garlick Peter J. , Wernerman Jan 
Published: March 2004

SummaryIn previous studies, a decline in total liver protein synthesis during elective laparoscopic surgery has been observed. However, when albumin synthesis was measured in parallel no apparent influence of the procedure was detected. The aim of the present study was to specifically investigate the effect of a laparoscopic procedure on albumin synthesis. Female (n = 9) patients scheduled for elective laparoscopic cholecystectomy as a consequence of cholecystolithiasis were investigated. The fractional synthesis rate (FSR) of albumin was investigated twice in each patient, before and during surgery (2–3 h apart), employing l‐[2H5]phenylalanine and gas chromatography mass spectrometry. The FSR of albumin decreased from 7·3 ± 1·2% per day before surgery to 6·2 ± 1·4% per day during the procedure (P<0·01), whereas the corresponding absolute synthesis rates of albumin decreased from 114 ± 24 to 86 ± 16 mg kg−1 day−1, respectively (P<0·001). In conclusion, the synthesis rate of albumin decreased during a laparoscopic surgery procedure. However, the characteristics for this decrease differ from those previously observed for total liver protein synthesis.
Blood flow and flow resistance in the vertebral arteries of patients with and without carotid atherosclerosis
Authors: Hallerstam Staffan , Rosfors Stefan 
Published: March 2004

SummaryIn the present prospective study colour duplex ultrasound was used to investigate the vertebral arteries in 117 patients referred for carotid duplex examination. The study aimed to identify flow abnormalities and factors influencing blood flow haemodynamics by calculating the resistance index (RI) in the vertebral and common carotid arteries. Vertebral artery RI was decreased in patients with severe carotid artery disease (≥80% stenosis or occlusion) caused mainly by an increased diastolic flow velocity. By contrast, patients without severe carotid artery disease showed an age‐related increase in vertebral artery RI. The RI in the common carotid artery was increased in patients with local atherosclerosis in the carotid bulb, and was increased with age. There was significantly better visualization of the right vertebral artery origin than of the left (75% versus 62%, P<0·05). Stenotic lesions were found in 15% of the carotid bifurcations and in 7% of the vertebral arteries. It is concluded that vertebral artery haemodynamics can be evaluated using colour duplex ultrasound; however, there are difficulties in visualizing the vertebral artery origin, especially on the left side. Even at advanced age, the vertebral arteries can reduce flow resistance to maintain cerebral blood flow in patients with occluded or severely stenosed carotid arteries. RI in vertebral arteries in patients without severe carotid occlusive disease, and in common carotid arteries, is mainly affected by local atherosclerosis and age, which increase the flow resistance.
Practical Evaluation of Methods for Detection and Specificity of Autoantibodies to Extractable Nuclear Antigens
Authors: Orton Susan M. , Peace-Brewer Amy , Schmitz John L. , Freeman Kristie , Miller William C. , Folds James D. 
Published: March 2004

ABSTRACTDetection and specificity of autoantibodies against extractable nuclear antigens (ENA) play a critical role in the diagnosis and management of autoimmune disease. Historically, the detection of these antibodies has employed double immunodiffusion (DID). Autoantibody specificity was correlated with diagnoses by this technique. Enzyme immunoassays have been developed by multiple manufacturers to detect and identify the specificity ENA autoantibodies. To address the relationship of ENA detection by DID and enzyme immunoassay, the performances of five immunoassays were compared. These included two DID and three enzyme-linked immunoassays (ELISA) (both screening and individual antigen profile kits). The sample set included 83 ENA-positive, antinuclear-antibody (ANA)-positive specimens, 77 ENA-negative, ANA-positive specimens, and 20 ENA- and ANA-negative specimens. Sensitivity and specificity were calculated by two methods: first, by using the in-house DID result as the reference standard, and second, by using latent class analysis, which evaluates each kit result independently. Overall, the results showed that the ELISA methods were more sensitive for detection of ENA autoantibodies than DID techniques, but presence and/or specific type of ENA autoantibody did not always correlate with the patient's clinical presentation. Regardless of the testing strategy an individual laboratory uses, clear communication with the clinical staff regarding the significance of a positive result is imperative. The laboratory and the clinician must both be aware of the sensitivity and specificity of each testing method in use in the clinical laboratory.
HOSTAGES DURING THE FIRST CENTURY OF THE CRUSADES
Authors: Kosto Adam 
Published: March 2004

AbstractThe use of hostages as a means of guarantee was most common in the medieval period in diplomatic and military encounters. The Crusades offer an excellent opportunity to study this institution in the context of intercultural relations and conflict. After briefly considering precedent traditions in Western Europe, Byzantium, and the Islamic world, this article examines the various specific functions hostages served: as guarantors of short-term agreements, such as those for safe passage or for the end of a siege, and of longer-term undertakings, such as treaties, alliances, and promises of ransom. The siege of Acre brings together many of these various functions in a single episode. The article closes by addressing two questions: the effectiveness of hostages as a means of surety; and the role of cultural difference in determining the outcome of hostage transactions and how they were viewed by contemporaries.
SUFISM'S ROLE IN AL-GHAZĀLĪ'S FIRST CRISIS OF KNOWLEDGE
Authors: Bargeron Carol 
Published: March 2004

AbstractThis paper reconstructs the chronology, content, and consequences of al-Ghazālī's first crisis of knowledge for his epistemological doctrine. In so doing, we explore his teaching on: 1) sense perceptions, 2) axiomatic cognitions, and 3) the knowledge-claims which are made on the basis of each source. We also explain why his skepticism emerged, what its exact dimensions were, how his skeptical interlude ended, and what the restoration of certitude about rational knowledge entailed for him in the approximate period between 461/1068-1069 and 488/1094-1095. In answering these questions, we emphasize and clarify the role that popular Sufism, especially in terms of its doctrine of esoteric knowledge or ma'rifa, played in the formation of al-Ghazālī's essential perspective on rational knowledge.
TRANSLATING SICILY
Authors: Mallette Karla 
Published: March 2004

AbstractThis article sketches a theoretical strategy for approaching the literary history of Norman Sicily (centuries XI-XII). Because of its linguistic complexity—during the Norman era, Sicilians wrote in Arabic, Greek, and Latin—literary historians have resisted treating Siculo-Norman literature as a literary-historical category. Rather, the literature has been divided into three discrete, linguistically defined traditions, understood as colonial extensions of mainland literary traditions. Using a reading of Sicilian coins with multilingual inscriptions in order to examine the parallel use of multiple languages in a single "text," this article argues for a reconsideration of Sicilian literature of the era, one that looks at multilingualism not as a challenge to literary coherence but as constitutive of a literary culture.