bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sustained effects of pioglitazone vs. glibenclamide on insulin sensitivity, glycaemic control, and lipid profiles in patients with Type 2 diabetes
Authors: Tan M. H. , Johns D. , Strand J. , Halse J. , Madsbad S. , Eriksson J. W. , Clausen J. , Konkoy C. S. , Herz M. ,   for the GLAC Study Group
Published: July 2004

AbstractAims  This study compared the effects of 52 weeks’ treatment with pioglitazone, a thiazolidinedione that reduces insulin resistance, and glibenclamide, on insulin sensitivity, glycaemic control, and lipids in patients with Type 2 diabetes.Methods  Patients with Type 2 diabetes were randomized to receive either pioglitazone (initially 30 mg QD, n = 91) or micronized glibenclamide (initially 1.75 mg QD, n = 109) as monotherapy. Doses were titrated (to 45 mg for pioglitazone and 10.5 mg for glibenclamide) to achieve glycaemic targets during the next 12 weeks: fasting blood glucose of ≤ 7 mmol/l and 1‐h postprandial blood glucose of ≤ 10 mmol/l. Patients were maintained on the titrated dose for 40 weeks.Results  Pioglitazone significantly increased insulin sensitivity compared with glibenclamide, as assessed by homeostasis model assessment (17.0% vs. −13.0%; P < 0.001), quantitative insulin sensitivity check index (0.011 vs. −0.007; P < 0.001) and fasting serum insulin (−1.3 pmol/l vs. 23.8 pmol/l; P = 0.007). The glibenclamide group had significantly lower HbA1c than the pioglitazone group after 12 weeks of therapy (7.8% vs. 8.3%, P = 0.015), but significantly higher HbA1c after 52 weeks of therapy (7.8% vs. 7.2%, P = 0.001). Pioglitazone significantly (vs. glibenclamide) increased mean HDL‐C (P < 0.001), decreased mean triglycerides (P = 0.019), and decreased mean atherogenic index of plasma (AIP; P = 0.001) and mean total cholesterol/HDL‐C (P = 0.004), without significantly elevating mean total cholesterol or mean LDL‐C compared with glibenclamide.Conclusions  These data suggest that the effects of pioglitazone are more sustained than those of glibenclamide for improving insulin sensitivity in patients with Type 2 diabetes, and that 52 weeks’ treatment with pioglitazone has favourable effects on glycaemic control and lipoprotein profile.
Targeted screening for undiagnosed diabetes reduces the number of diagnostic tests. Inter99(8)
Authors: Glümer C. , Jørgensen T. , Borch‐Johnsen K. 
Published: July 2004

AbstractAims  To determine the cost and performance of a Danish risk score, fasting plasma glucose (FPG), and HbA1c as single screening tests and in combination with targeted screening.Subjects and methods  In the Inter99 study, 12 934 inhabitants of Copenhagen County were invited to participate. All participants underwent anthropometric measurements, blood samples, and a 75‐g standardized oral glucose tolerance test [N = 6784 (52.5%)].Results  Of the 6117 individuals included in the analysis, 252 (4.1%) had previously undiagnosed diabetes. As a stand‐alone test, the FPG had the highest performance expressed by a significantly higher area under the receiver–operating curve [0.89; 95% confidence interval (CI) 0.86, 0.99] compared with the Danish risk score (0.78; 95% CI 0.76, 0.81) and HbA1c (0.76; 95% CI 0.72, 0.80). Targeted screening where the initial test was a risk score reduced the FPG measurements by 72% (100% vs. 27.8%). Using FPG in population‐based screening, the cost per newly diagnosed diabetic individual was 583 euro compared with 270 euro if screened by questionnaire followed by FPG. The sensitivity and specificity were 78.6% and 87.7% for FPG, and 61.5% and 89.2% for the combination of the questionnaire and FPG, respectively.Conclusions  The performance of FPG was superior to a questionnaire and HbA1c used as single tests. However taking into account workload, the burden on the population and the cost per identified person with undiagnosed diabetes, targeted screening using a questionnaire followed by FPG appears to be the strategy of choice.Diabet. Med. (2004)
Effects of cardiac rehabilitation on exercise capacity in Type 2 diabetic patients with coronary artery disease
Authors: Vergès B. , Patois‐Vergès B. , Cohen M. , Lucas B. , Galland‐Jos C. , Casillas J. M. 
Published: July 2004

AbstractAim  To determine whether Type 2 diabetic patients with coronary disease can obtain, after cardiac rehabilitation, a similar benefit on exercise capacity to non‐diabetic coronary individuals.Research design and methods  Fifty‐nine Type 2 diabetic patients and 36 age‐matched non‐diabetic patients were enrolled in a 2‐month cardiac rehabilitation programme, after an acute coronary event. At the beginning and at the end of the cardiac rehabilitation programme, each subject underwent a cardiopulmonary exercise test to assess exercise capacity as measured by peak workload, duration of test, maximal heart rate, peak VO2 and anaerobic threshold. The two groups of patients were not different in age, sex ratio, type of coronary event or left ventricular ejection fraction.Results  The baseline exercise capacity parameters were not different between diabetic and non‐diabetic subjects. After cardiac rehabilitation, improvement of exercise capacity was significantly less in patients with diabetes compared with those without diabetes: peak workload (19% vs. 29%, P = 0.022), peak VO2 (13% vs. 30%, P = 0.002), anaerobic threshold (12% vs. 31%, P = 0.017). In the diabetic patients, a significant inverse relation between fasting blood glucose and change in peak VO2 was observed on both univariate (r = −0.40, P = 0.002) and multivariate (P = 0.001) analyses.Conclusions  The benefit of cardiac rehabilitation, after an acute ischaemic heart event, in exercise capacity is significantly lower in Type 2 diabetic patients. The response to cardiac rehabilitation in those with diabetes appears to be influenced by blood glucose levels.
Baseline characteristics in the Collaborative AtoRvastatin Diabetes Study (CARDS) in patients with Type 2 diabetes
Authors: Thomason M. J. , Colhoun H. M. , Livingstone S. J. , Mackness M. I. , Betteridge D. J. , Durrington P. N. , Hitman G. A. , Neil H. A. W. , Fuller J. H. ,   the CARDS Investigators
Published: July 2004

AbstractAim  To describe baseline characteristics of patients in the Collaborative AtoRvastatin Diabetes Study (CARDS), a randomized, placebo‐controlled trial of lipid lowering with atorvastatin 10 mg daily for the primary prevention of major cardiovascular events in patients with Type 2 diabetes.Methods  The main eligibility criteria were Type 2 diabetes, age 40–75 years, no previous history of coronary heart disease, stroke or other major cardiovascular events, a documented history of at least one of retinopathy, micro‐ or macroalbuminuria, hypertension or current smoking, LDL‐cholesterol ≤ 4.14 mmol/l and triglycerides ≤ 6.78 mmol/l.Results  Randomization of 2838 persons (909 women) into CARDS was completed in June 2001. At entry, mean age was 62 years, 12% were over 70 years old and median duration of diabetes was 6 years. Median fasting lipid levels were total cholesterol 5.4 mmol/l, LDL‐cholesterol 3.1 mmol/l, HDL‐cholesterol 1.4 mmol/l and triglyceride 1.7 mmol/l. There was a documented history of retinopathy in 30% of patients, micro/macroalbuminuria in 11% (additionally 17% had micro/macroalbuminuria based on two elevated pretreatment measurements of albumin–creatinine ratios), hypertension in 79% and 23% were current smokers.Conclusion  CARDS will contribute importantly to the evidence for the macrovascular and microvascular benefits of lipid lowering with atorvastatin in patients with Type 2 diabetes. The results are likely to have important implications for the management of patients.
Social Support Networks of African‐American Children Attending Head Start: A Longitudinal Investigation of Structural and Supportive Network Characteristics
Authors: Bost Kelly K. , Vaughn Brian E. , Boston Ada L. , Kazura Kerry L. , O'Neal Colleen 
Published: July 2004

AbstractThis study examined the stability and coherence of African‐American children's social support networks. Participants included a total of 106 3‐ to 4‐year‐old children attending Head Start centers located in the southeast. Children completed a social network interview in two consecutive years at the Head Start centers. These interviews tapped multiple dimensions of the support network including social embeddedness, proportion of the network providing support, and perceived support. Analyses focused on both the rank‐order stability of children with respect to network characteristics as well as stability of network relationships (the same individuals included in the network at both time periods). Results indicated age‐related increases in network size for adult and child categories, network size across three support domains, proportion of support scores, and perceived support from adults. In addition to age‐related changes, analyses revealed considerable rank‐order stability with respect to structural network dimensions, but very little rank‐order stability in proportion of support and perceived support scores. In contrast, both structural and supportive components of the children's networks were shown to be coherent over a one‐year period when specific network member relationships were examined. Discussion highlights both continuities and discontinuities in young children's social networks, and how data obtained in this study contribute to theory building and the systematic examination of African‐American children's emerging social networks.
Perceptions of Achievement and Achieving Peers in U.S. and Chinese Kindergartners
Authors: Li Jin , Wang Qi 
Published: July 2004

AbstractTwo studies were conducted to examine perceptions about achievement and achiev‐ing peers in 190 U.S. and Chinese kindergartners. Children provided free‐narrative responses to story beginnings about an achieving protagonist in school settings. We found marked cultural differences. For achievement, U.S. children perceived more intellectual development, positive affects of the protagonist, and adult praise, where Chinese children perceived more social respect and their ability to help others. For lack of achievement in non‐achieving peers, U.S. children identified more negative affects, and Chinese children anticipated more negative reactions from adults. Moreover, although children in both cultures used non‐ability factors to explain achievement, Chinese children did so more consistently. Most strikingly, whereas Chinese children often expressed peer respect and desire to emulate the achieving protagonist, U.S. children frequently attributed peer negative reactions toward him or her. We interpret these differences as reflecting U.S. and Chinese cultural values regarding learning, achievement, and related self‐other perceptions.
Emotion Socialization as a Framework for Understanding the Development of Disorganized Attachment
Authors: DeOliveira Carey Anne , Bailey Heidi Neufeld , Moran Greg , Pederson David R. 
Published: July 2004

AbstractRecent years have seen the emergence of accounts of the origins of the Disorganized attachment relationship in early mother–infant interaction, each building on the pioneering work of Main and Hesse—dysfunctional emotional processes figure prominently in all these accounts. This paper applies a framework based on two complementary theories of emotion socialization, Gianino and Tronick's (1992) Mutual Regulation Model and Gergely and Watson's (1996) Social Biofeedback Theory, to suggest an emotion‐based mechanism consistent with recently proposed models of the development of Disorganized attachment. The framework is used to generate hypothetical accounts of the role of dysfunctional emotional processes and maladaptive emotion socialization in early mother–infant interaction in the development of Disorganized attachment along two distinct pathways, one associated with actual abuse of the infant and the other associated with maternal unresolved trauma.
Positively charged porphyrins: a new series of photosensitizers for sterilization of RBCs
Authors: Trannoy Laurence L. , Lagerberg Johan W.M. , Dubbelman Tom M.A.R. , Schuitmaker Hans J. , Brand Anneke 
Published: July 2004

BACKGROUND:  Photodynamic treatment could be a way to inactivate pathogens in RBCs. The objective of this study was to characterize the virucidal activity and RBC‐damaging activity of a series of cationic porphyrins. Using the most efficacious photosensitizer, various in‐vitro human RBC quality variables and in‐vivo RBC survival in Rhesus monkeys were evaluated.STUDY DESIGN AND METHODS:  RBCs, spiked with 5 log of extracellular VSV, were treated with porphyrins (25 µmol/L) and red light (100 W/m2) and essayed for virucidal activity. In‐vitro RBC quality variables were assessed during 5 weeks of storage in various ASs. In‐vivo survival was investigated with autologous RBCs in Rhesus monkeys.RESULTS:  Tri‐P(4) was by far the best sensitizer of a series tested, giving the least hemolysis under conditions that resulted in 5 log‐kill of extracellular VSV. Under our experimental conditions, the percentage hemolysis in treated cells was 5.1 ± 1.1 percent after 5 weeks of storage in SAG‐M compared to 1.9 ± 1.1 percent in the untreated control. Storage in AS‐3 resulted hemolysis of 2.3 ± 1.9 percent. With the exception of IgG binding and potassium leakage, RBC quality variables remained unchanged after photodynamic treatment. Addition of reduced glutathione (GSH) during treatment reduced IgG binding. The 24‐hour recovery and T50 of treated RBCs in Rhesus monkeys were satisfactory.CONCLUSION:  Porphyrin Tri‐P(4) may be a suitable photosensitizer for sterilization of RBCs. However, further exploration to optimize the method is necessary to reach clinically acceptable goals.
Multicenter evaluation of a whole‐blood filter that saves platelets
Authors: Paunovic Dragica , Van Der Meer Pieter , Kjeldsen‐Kragh Jens , Kekomaki Riitta , Larsson Stella , Greppi Noemi , Porretti Laura , Balint Bela , Trkuljic Miroljub , Nedeljkovic Ninoslav , Simonovic Ruzica , Massaro Anna , Labanca Luciana , Kora Shinichi , Riggert Joachim 
Published: July 2004

BACKGROUND:  Whole‐blood (WB) leukoreduction filters in current use retain the majority of PLTs. A new whole‐blood filter, which retains significantly fewer of the PLTs (or saves PLTs [WB‐SP]), has been developed. The performance characteristics of the WB‐SP filter have been evaluated in a multicenter study.STUDY DESIGN AND METHODS:  A total of 617 units of WB was collected into quadruple bag sets with an integrated WB‐SP filter, leukoreduced, and processed into leukoreduced RBCs (LR‐RBC), plasma (LR‐PL), and buffy coats (LR‐BC) from which, pooled, leukoreduced, PLT concentrates (LR‐PCs) were produced. Recovery, yield, and residual WBCs were assessed in prepared blood components.RESULTS:  The median residual WBC number in the LR‐RBCs was 0.05 × 106 (range, <0.05‐3.8), exceeding 1 × 106 in 0.6 percent of the units. Median Hb content in LR‐RBC was 50 g (range, 34‐72), reflecting a final RBC recovery of 81 ± 6 percent. The median WBC content of the LR‐PC was 0.05 × 106 (range, <0.05‐0.28), with none exceeding 1 × 106. The median PLT content of the LR‐PC, per individual donation, was 6.4 × 1010 (range, 4.1‐10.7), representing a final recovery of 62 ± 10 percent. The mean FVIII activity was 104 ± 25 percent and 83 ± 11 percent in plasma separated from fresh or overnight stored WB, respectively.CONCLUSION:  Use of the WB‐SP filter makes it possible to obtain three leukoreduced blood components with only one filtration step. The WB‐SP filter showed good leukoreduction performance and recovery of all blood components including PLTs.
Photochemical treatment of platelet concentrates with amotosalen hydrochloride and ultraviolet A light inactivates free and latent cytomegalovirus in a murine transfusion model
Authors: Jordan Catherine T. , Saakadze Natia , Newman James L. , Lezhava Levan J. , Maiers Tanya T. , Hillyer Whitney M. , Roback John D. , Hillyer Christopher D. 
Published: July 2004

BACKGROUND:  A photochemical treatment (PCT) process utilizing amotosalen hydrochloride and long wavelength UVA light has been developed to inactivate pathogens in PLTs. This study investigated the effects of amotosalen/UVA treatment on free and latent murine CMV (MCMV) in PLT preparations using a murine model of transfusion‐transmitted CMV (TT‐CMV).STUDY DESIGN AND METHODS:  In a model of latent MCMV infection, “donor” mice received 1 × 106 plaque‐forming units (PFUs) MCMV and were rested 14 days. Subsequently harvested, pooled, and washed WBCs were PCR positive for MCMV. Murine WBC doses of 1 × 104, 1 × 105, and 1 × 106 were added to human apheresis PLTs in 35 percent autologous plasma and 65 percent PLT AS (PAS). The WBC‐PLT products were treated with 150 µmol/L amotosalen and 0.6 J per cm2 UVA and transfused via tail vein injection into recipient mice. Recipients were killed on Day 14. Blood and spleens were collected and assayed for MCMV by PCR. In a parallel model of active infection with free virus, human PLT in 35 percent autologous plasma and 65 percent PAS were dosed with 1 × 105 and 1 × 106 PFUs of MCMV. All other procedures were as described above.RESULTS:  In the absence of amotosalen/UVA‐pretreatment, transfusion of PLT latently or actively infected with MCMV produced TT‐CMV in a dose‐dependent fashion. In contrast, all transfusion recipients of identical PLT preparations pretreated with amotosalen/UVA were uniformly PCR negative for MCMV (abrogation of TT‐CMV; p < 0.05).CONCLUSIONS:  PCT of PLT preparations with the specified doses of amotosalen hydrochloride and UVA light prevents transfusion transmission of free and latent MCMV in a murine model. These results suggest that PCT of human PLTs with amotosalen/UVA should also effectively abrogate TT‐CMV in the clinical setting.
Pregnancy outcomes after recovery from thrombotic thrombocytopenic purpura–hemolytic uremic syndrome
Authors: Vesely Sara K. , Li Xiaoning , McMinn J.R. , Terrell Deirdra R. , George James N. 
Published: July 2004

BACKGROUND:  Recurrent thrombotic thrombocytopenic purpura–hemolytic uremic syndrome (TTP‐HUS) during a subsequent pregnancy is an important concern because pregnancy may increase the risk for relapse.STUDY DESIGN AND METHODS:  Outcomes of all pregnancies after recovery from TTP‐HUS in the Oklahoma TTP‐HUS Registry, a cohort of 301 consecutive patients during the period of 1989 through 2003, were assessed and compared to the total published experience.RESULTS:  In the Oklahoma Registry, 3 of 7 (43%) women with idiopathic TTP‐HUS, 2 of 11 (18%) women who were pregnant/postpartum, and 0 of 1 (0%) woman with a bloody diarrhea prodrome at their initial presentation were diagnosed with TTP‐HUS during a subsequent pregnancy; all 5 women recovered. In published reports, 10 of 11 (91%) women with idiopathic TTP‐HUS and 11 of 18 (61%) women who were pregnant/postpartum at their initial presentation, and all 11 (100%) women with congenital TTP‐HUS were diagnosed with TTP‐HUS during a subsequent pregnancy. Rates of recurrence in the Oklahoma Registry may be less because of case report bias for exceptional patients. Recurrent TTP‐HUS was difficult to diagnose because other pregnancy‐related complications were frequent.CONCLUSIONS:  Although pregnancies in these women were often complicated, a future pregnancy may be a safe and appropriate decision for women who have recovered from TTP‐HUS.
Prestorage pooled whole‐blood–derived leukoreduced platelets stored for seven days, preserve acceptable quality and do not show evidence of a mixed lymphocyte reaction
Authors: Sweeney Joseph D. , Kouttab Nicola M. , Holme Stein , Kurtis Jonathan D. , Cheves Tracey A. , Nelson Edward J. 
Published: July 2004

BACKGROUND: Prestorage pooling of whole‐blood–derived PCs (WBD‐PCs) would be advantageous to transfusion services in that it would make the product available in a more timely manner, reduce wastage of untransfused pools, and simplify bacterial screening by allowing testing of the pool rather than each single PLT concentrate (PC).STUDY DESIGN AND METHODS: Four to six individual leukoreduced PCs were pooled into a 1.5‐L CLX‐HP PLT storage bag using a sterile connecting device. Controls were individual prestorage leukoreduced PCs that were stored as single products. Products were sampled on Days 5 and 7 for measures of PLT quality; coagulation, fibrinolytic and complement activation; and for evidence of a mixed lymphocyte reaction.RESULTS: The pH level was well maintained to Day 7 with no prestorage pool having a pH below 6.7. Day 7 studies showed no evidence of coagulation or difference in complement activation. F1.2 levels did not differ between Days 5 and 7, but a 10‐ to 15‐percent increase in C3a des‐Arg was observed between these days in all product types. Day 7 activated lymphocyte surface markers (CD69, CD71, HLA‐DR) were all at lower limits of detection in the prestorage pooled products, and levels of supernatant cytokines were either not different between product types on either study day or, if different, were lower in the prestorage pooled products.CONCLUSION: There is no evidence of a deterioration in quality, activation of coagulation or complement, or a mixed lymphocyte reaction attributable to the prestorage pooling process with up to 7 days of storage.
Decreased deformability of donor red blood cells after intrauterine transfusion in the human fetus: possible reason for their reduced life span?
Authors: Egberts J. , Hardeman M.R. , Luykx L.M. 
Published: July 2004

BACKGROUND:  The life span of donor red blood cells (RBCs) is reduced in the fetus with Rh hemolytic disease. This may have resulted from donor or recipient factors.STUDY DESIGN AND METHODS:  Studied in vitro was the effect of gamma irradiation on hemolysis, methemo‐globin (metHb), and lipid peroxidation of donor RBCs and the ability of fetal and adult plasma to protect irradiated RBCs from induced lipid peroxidation. Also studied in vivo were the effects after the time that donor RBCs reside in the fetus by measuring its lipid peroxidation, cholesterol‐to‐phospholipid ratios, and deformability of RBCs.RESULTS:  Irradiation barely increased hemolysis and metHb formation and did not increase lipid peroxidation. Plasma samples of D+ fetuses inhibited induced oxidative stress less than plasma samples of adults. Nevertheless, in vivo lipid peroxidation of the donor RBC membrane had not increased, whereas the molar cholesterol‐to‐phospholipid ratio increased from 1.08 ± 0.11 to 1.38 ± 0.12. It became identical to that of the fetal RBCs (1.44 ± 0.12). Before transfusion, the deformability of the adult RBCs (elongation index, 0.578 ± 0.013) was better than that of the fetal cells (elongation index, 0.494 ± 0.027), but decreased to fetal levels after transfusion (elongation index, 0.518 ± 0.039).CONCLUSION:  Irradiation of the RBCs and a reduced fetal antioxidant capacity do not lead to in vivo lipid peroxidation. The shorter life span of donor cells in the fetus probably results from a decreased deformability of the RBCs after transfusion, most likely owing to an increased cholesterol‐to‐phospholipid ratio.