bluuebunny/crossref_metadata_2025_split huggingface dataset:
Managing many patients with a urethral stricture:
Authors: Ogbonna  
Published: July 2002

Objectives To report a management method in a community where there are many patients with urethral stricture and where the short‐term goal of providing some treatment to most may override the sometimes conflicting long‐term aim of minimizing recurrence rates.Patients and methods Over a 3‐year period, using optical urethrotomy in 76 patients followed by intermittent self‐dilatation (ISD) in 29, urethroplasty in 28 and dilatation in three, 92 of 134 patients with a urethral stricture were treated and the outcome compared.Results The overall recurrence rate was 22%; a combination of urethrotomy plus ISD had a recurrence rate of 17% and gave a mean duration of follow‐up without recurrence similar to that after urethroplasty. ISD significantly increased both the time before recurrence and the duration of follow‐up without recurrence after urethrotomy. In addition to providing lasting treatment to many patients, urethrotomy was also 10 times cheaper, 10 times faster to perform and offered the surgeon better protection from infection with human immunodeficiency virus than did urethroplasty.Conclusion Because wrongly selecting urethrotomy (resulting in a failed procedure) wastes valuable operating time and resources, the pre‐operative recognition of strictures unsuitable for urethrotomy and their treatment by urethroplasty is important for overall efficiency.
Impact of cigarette smoking on the incidence of Type 2 diabetes mellitus in middle‐aged Japanese men: the Osaka Health Survey
Authors: Uchimoto S. , Tsumura K. , Hayashi T. , Suematsu C. , Endo G. , Fujii S. , Okada K. 
Published: July 2002

Summary Aims To assess the impact of cigarette smoking on the incidence of Type 2 diabetes mellitus (DM) in middle‐aged Japanese men. Methods The study enrolled 6250 men aged 35–60 years and free of diabetes, impaired fasting glucose and hypertension at entry. Type 2 DM was defined by a fasting plasma glucose level ≥ 7.0 mmol/l or physician‐diagnosed Type 2 DM. Results Four hundred and fifty cases of Type 2 DM were confirmed during the 60 904 person‐years follow‐up. After adjustment for multiple covariates, including age, body mass index, alcohol consumption, physical activity, parental history of diabetes and the level of fasting plasma glucose, total cholesterol, triglycerides, high‐density lipoprotein cholesterol and haematocrit, the relative risk of Type 2 DM among current smokers compared with non‐smokers was 1.47 (95% confidence interval (CI) 1.14–1.92). Men who smoked > 30 cigarettes/day had a multivariate‐relative risk of 1.73 (95% CI 1.20–2.48) compared with non‐smokers. The number of cigarettes smoked daily and the pack‐year values were positively related to the development of Type 2 DM in a dose‐dependent manner (P for trends = 0.0026 and 0.001, respectively). Conclusions A cigarette smoking habit is an independent risk factor for Type 2 DM.
Application of the new ADA criteria for the diagnosis of diabetes to population studies in sub‐Saharan Africa
Authors: Levitt N. S. , Unwin N. C. , Bradshaw D. , Kitange H. M. , Mbanya J. ‐C. N. , Mollentze W. F. , Omar M. A. K. , Motala A. A. , Joubert G. , Masuki G. , Machibya H. 
Published: July 2002

Summary Aims To examine the implications for epidemiological studies of the American Diabetes Association (ADA) recommendation that the fasting blood glucose at a lowered level becomes the main diagnostic test for diabetes on cross‐sectional‐based data from sub‐Saharan Africa. Methods Data from 11 surveys conducted in rural, peri‐urban and urban Cameroon (n = 1804), South Africa (n = 3799) and Tanzania (n = 10013) which measured fasting (ADA criteria) and 2‐h blood glucose concentrations during a standard 75 g OGTT (old WHO criteria) were analysed.Results The prevalence of diabetes was higher in eight of the 11 surveys when applying the new ADA compared to the old WHO criteria. With the exception of one population (Mara, Tanzania) the absolute difference in prevalence between the two classifications tended to be small (< 2%). There was considerable variation in the categorization of individuals using the ADA and old WHO criteria. The level of agreement between the two ranged from fair to good (Kappa statistic 0.17–0.86). The prevalence of impaired fasting glycaemia (IFG) was lower than that of impaired glucose tolerance (IGT) in 10 of the surveys and the agreement between the two was fair,  0.26 in all the surveys. Conclusions Although the use of the new ADA fasting criteria for prevalence surveys is an attractive and practical option, particularly in Africa, further information is required on the characteristics and prognosis of individuals classified as IFG or diabetic by the fasting criteria, prior to wide adoption of the ADA criteria. Ideally measurement of both fasting and two low glucose concentrations should remain the standard for epidemiological studies.
HLA typing and immunological characterization of young‐onset diabetes mellitus in a Hong Kong Chinese population
Authors: Kelly M. A. , Chan J. C. N. , Heward J. , Mijovic C. H. , Zimmet P. Z. , Yeung V. T. F. , Cockram C. , Barnett A. H. 
Published: July 2002

SUMMARY Aims  A study of the Hong Kong Chinese showed that the majority of subjects with young‐onset diabetes (age of diagnosis < 35 years) present with a phenotype suggestive of Type 2 diabetes mellitus, although up to 50% subsequently need insulin treatment. The aim of this study was to use a combination of clinical, genetic and immunological markers to characterize the disease phenotype further in such individuals and to determine whether the requirement for insulin is the result of autoimmune disease.Methods  One hundred and thirty‐seven Hong Kong Chinese with young‐onset diabetes were studied, irrespective of their mode of presentation. The subjects were typed for alleles of the HLA‐DR and ‐DQ genes and investigated for the presence of autoantibodies to glutamic acid decarboxylase (GAD). Plasma C‐peptide concentration and requirement for insulin were also determined.Results  One hundred and three subjects presented with a syndrome resembling Type 2 diabetes, while 34 presented with Type 1 diabetes. Of the former group, 35 patients (34.0%) were insulin‐deficient, 16 (15.5%) were insulin‐treated and seven (6.9%) were positive for GAD autoantibodies. Among the GAD‐positive subjects presenting with Type 2 diabetes, the HLA‐DRB1*03 allele may be a marker of early progression to insulin therapy.Conclusions  Seven subjects with Type 2 diabetes at presentation had autoantibodies to GAD. Causes other than GAD autoimmunity, however, must be sought to explain the high prevalence of insulin deficiency observed in the Chinese patients. This study highlights the heterogeneity of the pathogenic processes leading to the diabetic phenotype.
Doppler ultrasound imaging: a new technique to detect lung hypoplasia before birth?
Authors: Laudy J. A. M. , Gaillard J. L. J. , Anker J. N. V. D. , Tibboel D. , Wladimiroff J. W. 
Published: July 2002

AbstractCombined color‐coded Doppler and pulsed Doppler ultrasonography allows visualization 0f the fetal pulmonary circulation and study of pulmonary blood flow velocity waveforms. Systolic and diastolic changes were observed in fetal pulmonary artery flow velocity waveforms in a case of fetal pulmonary hypoplasia at 34 weeks of gestation. This observation supports our hypothesis that Doppler velocimetry can detect lung hypoplasia based on post‐ mortem examination of decreased total size of the pulmonary vascular bed, decreased number of pulmonary vessels per unit lung tissue and increased pulmonary vascular muscularization. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Effects of Vigabatrin on Brain GABA+/CR Signals in Patients with Epilepsy Monitored by 1H‐NMR‐Spectroscopy: Responder Characteristics
Authors: Mueller S. G. , Weber O. M. , Duc C. O. , Weber B. , Meier D. , Russ W. , Boesiger P. , Wieser H. G. 
Published: July 2002

Summary:  Purpose: Vigabatrin (VGB) is a new antiepileptic drug that increases the human brain γ‐aminobutyric acid (GABA) level by irreversibly inhibiting GABA transaminase. Although some patients respond to VGB with a significant seizure reduction, others do not. The aim of this study was to identify possible responders before or in an early phase of VGB treatment by measuring the GABA and homocarnosine contaminated with macromolecules/creatine and phosphocreatine ratio (GABA+/Cr) signal by means of proton‐nuclear magnetic resonance (1H NMR) spectroscopy.Methods: Measurements were performed immediately before and after a titration period of 1 month (2 g/day during the past 2 weeks). A third measurement followed a maintenance period of 3 months (2 or 3 g/day). In 14 patients with drug‐resistant temporal lobe epilepsy and 3 patients with occipital lobe epilepsy, GABA+/Cr was measured in the ipsilateral (i.e., epileptogenic) hemisphere and contralateral (i.e., nonepileptogenic) hemisphere in a volume of 8 cm3.Results: Depending on the therapeutic efficacy of VGB, we defined three groups: (a) full responders (n = 7), (b) nonresponders (n = 7), and (c) partial responders (n = 3). The nonresponders had no significant change in the GABA+/Cr signal during the treatment compared with baseline. The full responders had a significant increase of the GABA+/Cr signal during the whole treatment phase and a lower ipsilateral level at baseline. The partial responders had also a lowered ipsilateral GABA+/Cr signal at baseline and an increase during treatment but a decrease when the seizures started again.Conclusions: Responders to VGB could be identified by a lower ipsilateral baseline GABA+/Cr signal and a steeper increase during VGB treatment. However, it was not possible to predict the duration of the response (full versus partial responder) with these criteria.
The Validation of a Mailed Health Survey for Screening of Dementia of the Alzheimer's Type
Authors: Ball Linda J. , Ogden Allison , Mandi Deepak , Birge Stanley J. 
Published: July 2002

OBJECTIVE: To test the efficacy of a mailed health survey, which included the Clock Completion Test (CCT), to screen previously undiagnosed older adults for dementia of the Alzheimer's type (DAT) in a community‐dwelling population, and to determine whether the addition of selected risk factors for Alzheimer's disease (AD) would enhance the screening instrument's operating characteristics.DESIGN: Comparison of the results of a self‐administered screen for DAT with the diagnosis of DAT by clinician evaluation or telephone interviews.SETTING: A geriatric assessment clinic.PARTICIPANTS: Three hundred and five women age 65 and older from St. Louis, Missouri.MEASUREMENTS: The sensitivity and specificity of the CCT and the CCT plus risk factors for AD were evaluated using two standards: The Short Blessed Test (SBT) and the physician diagnosis of probable AD using National Institute of Neurological and Communicative Disorders and Stroke—Alzheimer's Disease and Related Disorders Association criteria.RESULTS: Sensitivity and specificity for the CCT by SBT criteria were 63% and 79%, respectively. Using the physician's assessment as a criterion, the CCT had better sensitivity (67%) but poorer specificity (69%). Adding two or more risk factors for AD improved sensitivity and specificity to 71% and 89% and, in the physician assessment subgroup, to 75% and 87%, primarily by halving the false‐positive rate.CONCLUSION: The combination of the simple, self‐administered CCT and two or more AD risk factors is a more effective screening instrument for DAT and potentially preclinical DAT than the CCT alone. However, the instrument may be better suited for use in an office setting because of a poor response rate by subjects with dementia.
The role of substitute therapy in the treatment of problem amphetamine use
Authors: KLEE HILARY , WRIGHT SAMANTHA , CARNWATH TOM , MERRILL JOHN 
Published: July 2002

AbstractThe aim of the project was to examine the effectiveness of treatment services for amphetamine users in the North West of England. Semi‐structured interviews were conducted by researchers in a longitudinal matched case‐control design in which each client was matched with an amphetamine user not in contact with services. Interviews yielded quantitative data which were subjected to standard statistical tests, and also rich qualitative data that provided further insights into their attitudes and behaviour. This paper reports on the subgroup of drug agency clients who were prescribed dexamphetamine (PDAs) and the changes in their use of street amphetamine. Analyses comparing prescribed clients with their controls revealed a significant reduction in amount and frequency of street amphetamine consumption over the first 3 months of treatment. Such changes in amphetamine use were most marked in the first month of treatment. Comparisons between PDAs and clients in treatment but not receiving a prescription (NPDAs) revealed that the reduction in amount was greater for the prescribed clients. There was no difference in the frequency of use between these client groups. Different patterns of change were observed among injecting clients. Retention in treatment was significantly greater for PDAs. Clients' compliance with treatment regimens and the concerns of health professionals about substitute prescribing with dexamphetamine were revealed through qualitative analyses.
Characteristics of amphetamine users seeking information, help and treatment in Adelaide, South Australia
Authors: VINCENT NIKI , SHOOBRIDGE JODIE , ASK ALEX , ALLSOP STEVE , ALI ROBERT 
Published: July 2002

AbstractThis study was designed as a needs assessment for interventions to respond to hazardous and harmful amphetamine use, including options for treatment. Research techniques from Rapid Assessment Methodology (RAM) were utilized to collect data. This included a survey of 100 amphetamine users, from which the data for the current paper has been drawn. This paper is focused on the characteristics of those who had sought information and help in the sample, and on those who were dependent on amphetamine and who felt they needed treatment, in comparison to those who were also dependent but did not feel the need for treatment. Findings in regard to treatment‐seekers were largely consistent with previous Australian and overseas research, and thus underscore the importance of considering psychological morbidity, both prior and subsequent to amphetamine use, in treatment settings for amphetamine users. Having previously sought general information about amphetamines, safer drug use and blood‐borne diseases was best predicted by higher sexual risk‐taking and poorer physical functioning. Having previously sought help for an amphetamine‐related concern or problem was best predicted by higher severity of dependence on amphetamines and poorer social functioning. Peers were considered to be important sources of information and help, as were GPs. In developing interventions for amphetamine users, consideration should be given to the characteristics of those who seek particular types of assistance.
Book and media reviews
Authors: COOK CHRIS 
Published: July 2002

Books reviewed in this article:Book reviews in this column will primarily be of titles focusing completely, or in part, on biological aspects of addiction. However, significant titles of general relevance to the addictions field will also be included, even if they are not “biological”, as will titles of general methodological and clinical relevance, even if they are not on “addictions”. Similar considerations will apply to other media (software, audio tapes and CDs, videos, etc). However, specific “addictions” software applications seem to be relatively uncommon and, as these items are rarely reviewed elsewhere, we will endeavour to include reviews of some of the older programmes that are still useful, as well as new titles that appear. I would appreciate suggestions of any items suitable for reviews, but especially software and other media of specific relevance to the addictions. Please contact: Professor Chris Cook, Kent Institute of Medicine and Health Sciences, University of Kent at Canterbury, Kent CT2 7NR, UK. Email: c.c.h.cook@ukc.ac.uk Cocaine: Effects on the Developing Brain J.A. HARVEY & B.E. KOSOFSKY (Eds) Co‐morbidity in Affective Disorders MAURICIO TOHEN (Ed.) Designer Drugs Directory KARL VALTER & PHILIPPE ARRIZABALAGA Forbidden Drugs, 2nd edn PHILIP ROBSON Aviation Medicine, 3rd edn J. ERNSTING, A. N. NICHOLSON & D. J. RAINFORD Research in Medicine: Planning a Project to Writing a Thesis GEORGE MURELL, CHRISTOPHER HAUNG & HAROLD ELLIS Multivariable Analysis: a Practical Guide for Clinicians MITCHELL H. KATZ Statistical Genomics: Linkage, Mapping and QTL Analysis BEN HUI LIU Spiritual Evolution J.M. TEMPLETON & K. S. GINGER The Troubled Helix—Social and Psychological Implications of the New Human Genetics THERESA MARTEAU & MARTIN RICHARDS (Eds)
Information processing deficits in withdrawing alcoholics
Authors: Keedwell Paul A. , Kumari Veena , Poon Lucia , Marshall E. JANE , Checkley Stuart A. 
Published: July 2002

AbstractPrepulse inhibition (PPI) of the acoustic startle response (a reduction in response to an intense, startling stimulus (the pulse) if preceded by 30–50 ms by a weaker, non‐startling stimulus) is an established model to index information processing deficits in thought‐disordered schizophrenic patients. The present study aimed to investigate the influence of alcohol withdrawal on the PPI effect. Eight withdrawing alcoholic patients underwent testing for PPI of the acoustic startle response (defined as percentage reduction of the response over pulse‐alone stimulus; prepulses 15 dB above the background) on three occasions (1, 3 and 7 days following the last drink). The results demonstrated remarkably low levels of PPI on days 1 and 3, with this being very robust in three patients who had a history of delirium tremens; there was a trend towards normalization of PPI on day 7. This study, although preliminary, suggests strongly that there is a deficit in the filtering of sensory information in alcohol‐dependent patients undergoing alcohol withdrawal. This was most apparent in those with a history of delirium tremens. Further studies are needed to define the cause and chronicity of these deficits.
Propofol dependency after treatment of tension headache
Authors: Schneider Udo , Rada Dominique , Rollnik Jens D. , Passie Thorsten , Emrich Hinderk M. 
Published: July 2002

AbstractPropofol is a widely used general anaesthetic with growing usage outside anaesthesia. Despite its potential for abuse only five cases of propofol dependency have yet been reported. These comprise health care professionals with easy access to the drug. This is the first reported case of propofol dependency in a lay person. One should be aware of the abuse potential of propofol with regard to its growing use outside the context of general anaesthesia.
Book and Media Reviews
Authors: Ball David 
Published: July 2002

Book reviewed in this article:Book reviews in this column will primarily be of titles focusing completely, or in part, on biological aspects of addiction. However, significant titles of general relevance to the addictions field will also be included, even if they are not “biological”, as will titles of general methodological and clinical relevance, even if they are not on “addictions”. Similar considerations will apply to other media (software, audio tapes and CDs, videos, etc.). However, specific “addictions” software applications seem to be relatively uncommon and, as these items are rarely reviewed elsewhere, we will endeavour to include reviews of some of the older programmes that are still useful, as well as new titles that appear. I would appreciate suggestions of any items suitable for reviews, but especially software and other media of specific relevance to the addictions. Please contact: Dr David Ball, National Addiction Centre, 4 Windsor Walk, London SE5 8AF, UK. Email: media@addictionbiology.com The Science of Marijuana L. L. IVERSEN Memory Disorders in Psychiatric Practice G. E. BERRIOS & J. R. HODGES (Eds) Drug Use and Prisons D. SHEWAN & J. B. DAVIES (Eds) Meta‐analysis in Medicine and Health Policy D. K. STANGL & D. A. BERRY (Eds) Brain Imaging in Clinical Psychiatry R. R. KRISHNAN & P. M. DORAISWAMY (Eds)
Carbohydrate deficient transferrin in alcoholic and non‐alcoholic liver disease: a comparison of two assay methods
Authors: KEATING JAMES , CHEUNG CONNIE , PETERS TIMOTHY J. , PRZEMIOSLO ROBERT , WILLIAMS ROGER , SHERWOOD ROY A. 
Published: July 2002

AbstractCarbohydrate‐deficient transferrin (CDT) was assayed in 105 patients with non‐alcohol‐related liver diseases, 50 patients with alcohol‐induced liver disease and 40 alcohol misusers with minimal hepatic dysfunction. The patients with liver disease were hospitalized for assessment of suitability for orthotopic liver transplantation. CDT was measured by two commercially available micro anion exchange methods; CDTect (Pharmacia) and %CDT (AXIS). Additionally, total transferrin was measured to allow expression of the CDTect results as ‘relative’ measurements. Overall, 41/105 (39%) of patients with non‐alcohol‐related liver diseases had a raised CDTect result, 13/105 (12%) had a raised %CDT result and 26/105 (25%) an abnormal CDTect/total transferrin ratio. In general, patients with cholestatic liver disease, primary biliary cirrhosis or primary sclerosing cholangitis had more ‘false positive’ results by CDTect than did those with viral or autoimmune hepatitis. The sensitivity of the two methods for the detection of alcohol misuse was similar; CDTect 77%, %CDT 65% and CDTect/total transferrin ratio 70%. This was, however, lower than the sensitivity of the conventional marker GGT (82%). In patients with severe liver disease, where up to 30% of the serum total transferrin concentrations fall outside the reference range, ‘relative’ CDT methods have greater specificity than ‘absolute’ measurements.
Metabolism of drugs of abuse by cytochromes P450
Authors: CHO ARTHUR K. , NARIMATSU SHIZUO , KUMAGAI YOSHITO 
Published: July 2002

AbstractStudies of most drugs of abuse utilize in vivo animal experimentation so that the responses measured reflect the pharmacokinetics of the administered drug as well as its pharmacodynamics. These drugs are generally lipid soluble chemicals and their elimination is dependent on metabolism, so an understanding of this process is critical to the interpretation of responses. This review summarizes the interaction between drugs of abuse and cytochromes P450, the oxidative enzymes that catalyze the first step of the metabolic process. Although they process their substrates by a common chemical mechanism, these enzymes differ markedly in their regulation, i.e. induction and inhibition, their substrate selectivities, the metabolites they generate and their relative concentration in different species. The activity of an enzyme catalyzing a specific metabolic reaction can be altered by prior xenobiotic exposure, by its genetics and by a co‐administered drug, so that the pharmacokinetics of the drug under study can vary with the history of the individual subject. These issues are obviously important in human studies so, when possible, the relevant human enzymes involved in the processes described have been identified.