bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sacral neuromodulation in functional urinary retention: an effective way to restore voiding
Authors: Aboseif S. , Tamaddon K. , Chalfin S. , Freedman S. , Mourad M.S. , Chang J.H. , Kaptein J.S. 
Published: March 2003

Objective  To determine the long‐term efficacy and complications of sacral nerve stimulation as an alternative therapy for functional unobstructive urinary retention, often considered to be psychogenic and effectively treated by clean intermittent catheterization, but for which pelvic floor dysfunction has been recognized as a possible cause.Patients and methods  Twenty patients (17 women and three men, mean age 48 years) with idiopathic, unobstructive functional urinary retention and in whom other forms of therapy had failed, had a pulse generator implanted (Medtronic, Minneapolis, MN, USA) and a sacral nerve implant. Their mean duration of symptoms was 68 months; 13 patients had chronic pelvic and perineal pain associated with their obstructive voiding symptoms. All patients were managed with clean intermittent catheterization and pharmacological therapy (α‐blockers) before the procedure. All patients had a percutaneous nerve evaluation before the permanent implant, which showed> 50% improvement in their symptoms. All patients were evaluated at 1, 6 12, 18 and 24 months, then yearly thereafter. The results were assessed both subjectively by patient's symptoms and objectively by checking the postvoid residual volume (PVR) and voided volume.Results  Eighteen patients were able to void spontaneously with a mean increase in voided volume from 48 to 198 mL, and a significant decrease in PVR from 315 to 60 mL. Eighteen of the patients had a ≥ 50% improvement in their symptoms and said they would recommend the therapy to a friend or relative. Complications occurred in six patients.Conclusion  Sacral nerve stimulation is an effective and durable new approach to functional urinary retention, with few associated complications. Test stimulation provides a valuable tool for selecting patients.
A ventral rotational skin flap to improve cosmesis and avoid chordee recurrence in epispadias repair
Authors: Pippi Salle J.L. , Jednak R. , Capolicchio J.P. , França I.M.P. , Labbie A. , Gosalbez R. 
Published: March 2003

Objective  To describe a technical modification that facilitates dorsal skin closure, improves cosmesis and eliminates chordee recurrence secondary to contracture of the dorsal penile skin in the repair of epispadias.Patients and methods  Eleven patients with penopubic epispadias (mean age 1.8 years) had the epispadias repaired using a modified ventral penile skin flap. Four patients had isolated epispadias and seven had had a previous primary closure of bladder exstrophy. Nine patients underwent the Cantwell‐Ransley technique, leaving the meatus in a glanular position. Two patients were repaired using the penile disassembly technique of Mitchell and Bägli, because they had a short urethral plate. A ventral island skin flap was fashioned, starting at the base of the penis. Dissection was carried ventrally into the scrotum to allow for adequate dorsal flap transposition. The flap was rotated laterally to shift the suture line from the midline and to cover the dorsal aspect of the penis with untouched penile shaft skin. Redundant ventral foreskin was discarded.Results  All patients had an uneventful course after surgery. Dorsal penile skin was viable in every case and no patient developed recurrence of chordee or a urethrocutaneous fistula. The cosmetic result was excellent in all patients.Conclusions  Dorsal skin closure using lateral rotation of ventral penile skin flap improves cosmesis after epispadias repair and eliminates the recurrence of chordee secondary to midline dorsal scarring.
MUC1 expression, splice variant and short form transcription (MUC1/Z, MUC1/Y) in prostate cell lines and tissue
Authors: Schut I.C. , Waterfall P.M. , Ross M. , O'Sullivan C. , Miller W.R. , Habib F.K. , Bayne C.W. 
Published: March 2003

OBJECTIVETo detect the expression and transcription pattern of MUC1 in benign and malignant disease, and in two widely studied cell lines, and to investigate the glycosylation of MUC‐1 in bone metastasis of prostate cancer, as mucins have been implicated in the progression and behaviour of several cancers.MATERIALS AND METHODSRNA extracted from cell lines (DU145 and PC3), five samples of BPH and five samples of prostate cancer was reverse transcribed before amplification of MUC1‐specific sequences by polymerase chain reaction. Paraffin‐embedded sections were stained for glycosylated MUC1 and MUC1 core epitopes by HMFG1 and B27.29 antibodies, respectively. Steroid‐treated cell lines werre analysed by fluorescence‐activated cell sorting, using the same antibodies.RESULTSMUC1, in an under‐glycosylated form, was widely expressed in the prostate and in metastatic lesions. MUC1/Z and MUC1/Y RNA were differentially expressed in BPH and prostate cancer, with no detectable expression of splice variant mRNA. This is in contrast to prostate cancer cell line cells (PC3 and DU145), which express splice variant mRNA.CONCLUSIONSBPH, prostate cancer and metastatic prostate cancer all express high levels of under‐glycosylated MUC1. This may explain the inability of previous studies to detect MUC1 in prostate tissue, as the antibody used was specific for a carbohydrate epitope which is not expressed on the under‐glycosylated MUC1.
In vivo evaluation of the potency and bladder‐vascular selectivity of the ATP‐sensitive potassium channel openers (–)‐cromakalim, ZD6169 and WAY‐133537 in rats
Authors: Fabiyi A.C. , Gopalakrishnan M. , Lynch J.J. , Brioni J.D. , Coghlan M.J. , Brune M.E. 
Published: March 2003

OBJECTIVETo compare in vivo the potency and bladder‐vascular selectivity of ATP‐sensitive potassium channel openers (KCOs) (–)‐cromakalim, WAY‐133537 and ZD6169 and a muscarinic antagonist, tolterodine in rats.MATERIALS AND METHODS Bladder and arterial pressures were monitored simultaneously, before and after increasing intravenous doses of compounds, in each of two urethane‐anaesthetized rat bladder hyperactivity models: spontaneous non‐voiding myogenic contractions secondary to partial outlet obstruction and volume‐induced neurogenic contractions.RESULTS(–)‐Cromakalim, WAY‐133537 and ZD6169 caused a dose‐dependent suppression of spontaneous contractions in the obstructed model, with a 50% inhibition of the contraction area under the curve at doses of 0.06, 0.14 and 2.4 µmol/kg (intravenous), respectively. Corresponding decreases in mean arterial pressure at these effective doses were 24%, 15% and 15%, respectively. The KCO potency rank order was the same and their relative potency highly comparable in the neurogenic model. There was complete inhibition of spontaneous contractions in obstructed rats at doses corresponding to ≈ 50% inhibition of the neurogenic contractions. While tolterodine caused a dose‐dependent inhibition of contractions in the neurogenic model, it was ineffective at inhibiting non‐voiding contractions in obstructed rats.CONCLUSIONSAll KCOs tested caused significant decreases in arterial pressure at doses effective on the bladder in the model of obstructive instability, suggesting a lack of bladder‐vascular selectivity. Similar KCO potency in both assays suggests no appreciable changes in KATP channel function as a result of partial outlet obstruction.
Productivity, vitality and utility in a group of healthy professionally active individuals with nocturia
Authors: Kobelt G. , Borgström F. , Mattiasson A. 
Published: March 2003

OBJECTIVESTo assess the effect of nocturia on productivity, vitality and utility in a selected group of professionally active individuals with nocturia, compared with matched controls, and investigate the effect of symptom severity, to test the hypothesis that lack of sleep caused by frequent sleep interruptions could reduce an individuals' daytime energy and activity levels.SUBJECTS AND METHODSSubjects (203) were recruited in Sweden through advertisements, and their suitability for the study assessed in a structured interview. Controls (80) matched for age and gender were randomly selected from a market research panel and given the same interview. Both groups completed a productivity questionnaire, a generic quality‐of‐life questionnaire with a specific domain for vitality and a utility instrument.RESULTSThe study group with nocturia had a significantly lower level of vitality and utility, and greater impairment of work and activity, than the control group. Women were more affected than men. Symptom severity correlated with all three measures.CONCLUSIONSIn an otherwise healthy and professionally active group of individuals, waking at night to void significantly diminishes their overall well‐being, vitality and productivity, leading to a significant level of indirect and intangible costs.
Diabetes UK funded surveys of the structural provision of primary care diabetes services in the UK
Authors: Williams D. R. R. , Baxter H. S. , Airey C. M. , Ali S. , Turner B. 
Published: March 2003

AbstractAim To describe diabetes service provision in primary care in the UK.Methods Postal questionnaires were sent to all UK primary care organizations (PCOs), and to a sample of general practices in England and all practices in Wales and Scotland. The data collection period ended on 30 April 2001.Results Seventy‐nine per cent of the PCOs and 40% of the practices provided usable information. There is evidence that respondents were not significantly biased in relation to their interest in diabetes care. Diabetes was included as a Health Improvement Programme (or equivalent) priority by 62% of PCOs and had been identified as a clinical governance priority by 27%. Sixty‐five per cent had information about the ethnic composition of their general population, 57% had an estimate of the number of people with diabetes. Sixty‐nine per cent had a local diabetes register but this was said to cover the entire local population in only 64% of these. At least one audit of diabetes care had been carried out (in the previous 5 years) in 75% and, in 76%, clinical guidelines on diabetes care were made available to practices. In the practices, 80% had a designated lead person for diabetes. Seventy‐three per cent had at least one general practitioner with a special interest and 87% at least one nurse. Seventy‐two per cent of practices ran specific diabetes clinics and 51% had a screening policy. Eighty‐six per cent considered that they had adequate systems in place for the delivery of diabetes care. However, only 6% were able to offer a dedicated diabetes telephone help or advice line and only 9% an evening out of hours clinic. Regular practice meetings were held to discuss diabetes in 35%, whereas 39% had a formal shared care protocol. Fourteen per cent held regular joint meetings with the hospital‐based team and in 38% there was membership of Diabetes UK for at least one partner or the practice itself. A third (34%) of responding practices were unsure whether a Local Diabetes Services Advisory Group or equivalent existed in their area. Geographical differences in service provision were identified with, for example, practices in London having fewer components in place that were specifically related to the provision of diabetes care. Single‐handed practices, wherever they were situated, had in place fewer staff and facilities specifically for diabetes care.
Association of British Clinical Diabetologists (ABCD): survey of specialist diabetes care services in the UK, 2000. 2. Workforce issues, roles and responsibilities of diabetes specialist nurses
Authors: Winocour P. H. , Ford M. , Ainsworth A. ,   the Association of British Clinical Diabetologists
Published: March 2003

AbstractAim To examine the provision and role of diabetes specialist nurses (DSNs), and the content of patient education programmes in the UK.Method A postal survey of secondary care providers of diabetes services in the UK in 2000.Results Following two reminders, a 77% response rate demonstrated 2.5 (median) whole time equivalent DSNs per 250 000 population, with only 13% of centres meeting the recommended staffing level of four per 250 000 population. The vast majority carried out work both in hospital and in the community, the proportion a reflection of who employed and managed staff. There was a wide variation in the qualifications required and the nursing gradings of DSNs, and regional variation in the number of grade I nurses, with the greatest proportion based in the South‐east of England. The vast majority (96%) provided patient education, and where it existed (in 60% of responses), were the major providers of a patient help line (90%). Although key providers of patient education, there had been no specific education for this task in over 20% of responses. There was broad consistency in the topics covered at educational sessions, although advice on footwear (76%) and home urine glucose monitoring (73%) were least frequently documented. The issuing of literature and cards for patient use was also very variable. Over 25% of bids for diabetes service improvement were for additional DSNs, but only 48% of these were successful.Conclusions There has been an improvement in staffing levels of DSNs over the last 10 years but the numbers are many fewer than recommended in national strategy documents, with evidence that despite expansion being given a high profile, such efforts are often unsuccessful. There was also evidence of considerable variation in the qualifications and gradings of DSNs throughout the UK and indeed in their day‐to‐day roles, and the content of patient education programmes. This suggests the need for a nationally co‐ordinated approach to training and recruitment.
Developing risk stratification charts for diabetic and nondiabetic subjects
Authors: Yudkin J. S. , Chaturvedi N. 
Published: March 2003

SummaryAims To provide estimates of the 10‐year risk of coronary heart disease events for diabetic and nondiabetic men and women with different levels of risk factors and, for diabetic subjects, with and without microalbuminuria.Methods Use of risk coefficients derived from the Framingham Study and a meta‐analysis of the influence of microalbuminuria on cardiovascular disease. The risk of a coronary heart disease event has been calculated for men and women with and without diabetes mellitus, and among diabetic subjects, with and without microalbuminuria, according to age, systolic blood pressure and the ratio of total to high density lipoprotein cholesterol.Results These risk estimates have been developed as a series of colour charts. The use of Framingham estimates of risk have been validated by comparing them with estimates derived from the Dundee Risk Disk and from the PROCAM Study, these estimates providing reasonable agreement despite the geographical and temporal differences in their development.Conclusions These charts permit the overall level of risk to be derived, which can inform decision making about thresholds for therapeutic interventions, as well as assisting in patient education.Diabet. Med. 16, 219–227 (1999)
Limited joint mobility in the hands and feet of adolescents with Type 1 diabetes mellitus
Authors: Duffin A. C. , Donaghue K. C. , Potter M. , McInnes A. , Chan A. K. F. , King J. , Howard N. J. , Silink M. 
Published: March 2003

Summary Aims Limited joint mobility (LJM) in the foot has not been assessed in adolescents with Type 1 diabetes mellitus (DM) but is associated with neuropathic ulceration in adults. This study was designed to determine the presence of LJM in adolescents with Type 1 DM and its association with microvascular disease. Methods The hands, feet and hips were examined in 302 diabetic adolescents and 51 nondiabetic controls (aged 11.5–20 years). LJM was defined as less than the fifth percent reference for controls.Results Reduced motion was found in 35% of diabetic adolescents at the subtalar (ST) joint, 18% at the first metatarsophalangeal (MTP) joint, 26% at the fifth metacarpophalangeal (MCP) joint and 13% had limited passive extension of the interphalangeal (IP) joints of the hands. Limited passive IP joint extension of the hands was not present in the controls. Limited active IP joint extension, a positive ‘prayer sign’, occurred in 35% of diabetic adolescents and 14% of controls. Diabetic adolescents showing LJM in any of these areas, except the prayer sign, were more likely to have retinopathy (odds ratio 2.53, CI: 1.53–4.18). Those with LJM in the foot were more likely to have albumin excretion rates > 7.5 μg/min (OR 2.06, CI: 1.16–3.68). Conclusion LJM in the feet of adolescents with Type 1 DM is associated with microvascular disease and is a useful routine clinical measure.Diabet. Med. 16, 125–130 (1999)
Plasma 1,5‐anhydroglucitol concentrations are influenced by variations in the renal threshold for glucose
Authors: Kilpatrick E. S. , Keevil B. G. , Richmond K. L. , Newland P. , Addison G. M. 
Published: March 2003

Summary Aims Measurement of serum 1,5‐anhydroglucitol (1,5AG) concentrations has been proposed as an alternative to HbA1c as both a marker of diabetic glycaemic control and as a screening test for diabetes. The sugar competes with glucose for renal tubular reabsorption, so hyperglycaemia leads to reduced serum 1,5AG concentrations through increased urinary loss. This study has sought to establish whether plasma 1,5AG can be influenced by not only hyperglycaemia, but by variations in renal threshold for glucose. Methods Thirty‐eight pregnant women (median age 30 years, range 20–43) found to be normoglycaemic after a 75‐g carbohydrate load had plasma 1,5AG and urine glucose measured. Results Using multivariate analysis, the presence and degree of detectable glycosuria at 2 h post glucose load was strongly predictive of a low plasma 1,5AG concentration (P = 0.0012) independently of fasting plasma glucose (P = 0.96), 2 h glucose (P = 0.029), subject age (P = 0.97) and gestation (P = 0.36). Thus, when matched for plasma glucose areas under the glucose load curve, 16 glycosuric subjects had significantly lower 1,5AG concentrations compared to 16 nonglycosuric ones (median 1,5AG 46 μmol/l (IQR 30–56) vs. 72 μmol/l (IQR 55–79, P = 0.017). Conclusions People with the same glucose tolerance may demonstrate variable plasma 1,5AG concentrations depending on their renal threshold for glucose. This inherent characteristic is likely to limit the usefulness of the test when monitoring or screening for diabetes.
Higher incidence of severe hypoglycaemia leading to hospital admission in Type 2 diabetic patients treated with long‐acting versus short‐acting sulphonylureas
Authors: Stahl M. , Berger W. 
Published: March 2003

Summary Aims A comparison of the frequency of severe hypoglycaemia leading to hospital admission in people with Type 2 diabetes mellitus (DM) treated with long vs. short‐acting sulphonylureas. Methods A community based study over a 12‐year period in the population of the city of Basle, Switzerland. The number of diabetic patients treated with oral hypoglycaemic agents was established on the basis of tablet consumption and a defined daily dose, e.g. 7.5 mg for glibenclamide, and 50 mg for glibornuride. Results Twenty‐eight Type 2 diabetic patients were admitted for severe hypo‐ glycaemia, with a median age of 73 years. There were no deaths. Sixteen of these admissions were patients treated with long‐acting sulphonylureas and 12 were patients treated with short‐acting forms. Only 23.5% of the population with Type 2 DM in Basle were treated with long‐acting sulphonylureas. With 30 345 person‐years of observation, the incidence of severe hypoglycaemia was 2.24 per 1000 person‐years for long‐acting sulphonylureas vs. 0.75 per 1000 person‐year for short‐acting forms, odds ratio 3.01 (95% confidence interval 1.35–6.77). Decreased food intake (nine patients) was a major contributing factor. Conclusions Severe hypoglycaemia leading to hospital admission is more common in elderly Type 2 diabetic patients treated with long‐acting compared to short‐acting sulphonylureas. Such long‐acting sulphonylureas should be avoided.
Delayed restoration of epidermal barrier function after suction blister injury in patients with diabetes mellitus
Authors: Koivukangas V. , Annala A. ‐P. , Salmela P. I. , Oikarinen A. 
Published: March 2003

Summary Aims Diabetes mellitus is a risk factor for compromised wound healing. The present study examines the restoration of the epidermal barrier function using the suction blister wound model. Methods The healing process was evaluated over time by measuring water evaporation (WE) and blood flow (BF) in the wound area. Seventeen Type 1 diabetic males and 11 non‐diabetic control males were studied. Results At the onset, the WE of diabetic patients was 116 ± 11 g.m–2.h–1 and that of controls 95 ± 13 g.m–2.h–1 (P < 0.001). On the second day, the WE of diabetic patients was 90 ± 21 g.m–2.h–1 and that of controls 60 ± 24 g.m–2.h–1 (P < 0.02). The most profound difference was encountered during the fourth day, when the WE of diabetic patients was 40 ± 17 g.m–2.h–1 and that of controls 14 ± 8 g.m–2.h–1 (P < 0.001). The value recorded on the fourth day was 37% of the onset value in diabetic patients and 16% in controls (P < 0.001). Eight days after wounding the values were close to that of normal skin in both diabetic and control subjects. At the onset, the BF was 93 ± 20 (arbitrary units) in diabetic men and 112 ± 18 in controls (P = 0.02). On the second, fourth and eighth day there was no significant differences. Conclusions The results suggest that restoration of the epidermal barrier function is delayed in the patients with diabetes. There were also a trend toward an initially weaker inflammatory response.
Metformin inhibits catecholamine‐stimulated lipolysis in obese, hyperinsulinemic, hypertensive subjects in subcutaneous adipose tissue: an in situ microdialysis study
Authors: Flechtner‐Mors M. , Ditschuneit H. H. , Jenkinson C. P. , Alt A. , Adler G. 
Published: March 2003

Summary Aims Metformin has been reported to decrease the plasma concentrations of non‐esterified fatty acids in Type 2 diabetic subjects. This study investigated the effects of metformin on basal and catecholamine‐stimulated lipolysis in abdominal subcutaneous adipose tissue of obese, hyperinsulinaemic, hypertensive subjects. Methods Fourteen subjects with severe obesity (12 female, two male, age 35.4 ± 4 years, body mass index 48.2 ± 2 kg/m2, body fat mass 63.3 ± 5 kg) were recruited. Glycerol and lactate concentrations were determined in the presence of metformin and after administration of catecholamines using microdialysis. Simultaneously, blood flow was assessed with the ethanol escape method. Results Glycerol release was lowered by metformin during the 3‐h experiment (P <  0.01). The lipolytic activity of catecholamines was suppressed when adipose tissue was pre‐treated with metformin (P <  0.001). Lactate concentration increased after application of metformin (P <  0.01) and catecholamines (P <  0.001). Blood flow was decreased in the presence of adrenaline (P <  0.01), but this effect was abolished by metformin. Conclusions The present data demonstrate the effects of metformin on lipolysis in subcutaneous adipose tissue in vivo. In the large body fat mass of obese subjects, a reduction of lipolysis in adipose tissue may contribute to a decrease of VLDL synthesis in the liver resulting in a lowered plasma triglyceride concentration.