bluuebunny/crossref_metadata_2025 huggingface dataset:
Abnormal proteolysis (DIC)—successful treatment with antithrombin III concentrate and a concentrate containing F XIII and native von Willebrand factor
Authors: DELSHAMMAR M. , LASSON Å. , NILSSON I.‐M. , OHLSSON K. , WALLMARK A. , VERNERSSON E.
Published: August 2009

Abstract. Two patients with life‐threatening disseminated intravascular coagulation (DIC) syndrome, one caused by Gram‐negative bacteria and one by premature separation of the placenta, are described.

Specific substitution was given by antithrombin III concentrate and AHF‐Kabi, a low purity factor VIII concentrate containing native von Willebrand factor and factor XIII. The treatment quickly returned the extremely low levels of antithrombin III, factor VIII; C, fibrinogen and factor XIII, initially found, to normal, and also returned the multimeric pattern of von Willebrand factor to normal. This resulted in diminished bleeding, enabling surgical treatment of the underlying disease.
Birthweights in the Faroe Islands: possible role of isovaleric acid
Authors: ACKMAN R. G.
Published: August 2009

Abstract. A high intake of n‐3 polyunsaturated fatty acids has been suggested as a factor in prolonged gestation in the population of the Faroe Islands. It is now suggested that isovaleric acid from pilot whales, a species frequently consumed in the Faroe Islands, may be the unusual dietary factor. Fatty acid data for eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA) in blood lipids of Faroese and Norwegians is reviewed in terms of the type of fish eaten, apparently mostly lean white fish with DHA ≫ EPA. The popular lean fish, thus, probably provides too little EPA to produce a marked effect on human biochemistry.
Radiological heart enlargement in treated hypertensive men: a comparative study of chest X‐ray examination and M‐mode echocardiography
Authors: SAMUELSSON O. , HARTFORD M. , WILHELMSEN L. , BERGLUND G. , WIKSTRAND J.
Published: August 2009

Abstract. Twenty‐five hypertensives with no history of myocardial infarction and with a radiologically determined heart enlargement were examined with M‐mode echocardiography and compared with a normotensive control group (n = 41). All except two of the hypertensive patients were on a β‐blocker based antihypertensive treatment regime.

The relative heart volume on X‐ray was significantly larger in the hypertensives, 562 ml m−2 body surface area (BSA), compared to the normotensives, 408 ml m−2 BSA (P < 0.001). Both left ventricular diameter (LVD) in end‐diastole and end‐systole and left arterial (LA) diameter were significantly larger in the hypertensives (56 vs. 51 mm, P < 0.01; 35 vs. 31mm, P < 0.01; 46 vs. 42 mm, P < 0.01. respectively) as was the LV mass (296 vs. 203 g, P < 0.001). The end‐systolic wall stress (ESWS) was significantly greater in the hypertensives. Despite these findings resting left ventricular fractional shortening was the same and showed a similar correlation with ESWS (r = 0.79 and r = 0.77, respectively) in both groups. Hence, left ventricular systolic performance was not impaired in the hypertensives compared to the normotensives.

These results show that an enlarged cardiac silhouette on the chest X‐ray in hypertensive subjects with β‐blocker based drug therapy must be interpreted with caution and must not, a priori, be judged as a sign of an impaired systolic cardiac function.
Effects of licorice on plasma atrial natriuretic peptide in healthy volunteers
Authors: FORSLUND T. , FYHRQUIST F. , FRØSETH B. , TIKKANEN I.
Published: August 2009

Abstract. Ingestion of licorice, 100 g daily for 8 weeks, caused a rise of 81% in plasma atrial natriuretic peptide (ANP) concentration in 12 healthy subjects. Mean body weight increment (1.6 kg) correlated with the increase in plasma ANP (r = 0.59; P < 0.01). The plasma concentrations of antidiuretic hormone, aldosterone, and plasma renin activity decreased. All these hormonal effects, reflecting retention of sodium and fluid volume, were probably due to the known mineralocorticoid properties of licorice. Blood pressure increased transiently and two subjects developed reversible hypertension. The rise in plasma ANP concentration during ingestion of licorice may be considered a physiological response to prevent fluid retention and development of hypertension.
A dose‐response study of amlodipine in mild to moderate hypertension
Authors: FRICK M. HEIKKI , McGIBNEY D. , TYLER H. M.
Published: August 2009

Abstract. The antihypertensive efficacy and suitability for once daily dosing of amlodipine, a new calcium antagonist, was studied in a series of 205 patients with mild to moderate hypertension. The study was conducted double‐blind in 13 centres. The starting doses of amlodipine were 1.25, 2.5 and 5 mg, respectively, which were doubled after 4 weeks if normotension or a preset target blood pressure was not reached. Target blood pressure was reached in 25% of patients with placebo, 41% with 2.5 mg of amlodipine, 56% with 5 mg of amlodipine and 73% with 10 mg of amlodipine once daily. The drug was well tolerated at all dose levels and no changes occurred in heart rate, body weight or electrocardiogram during treatment. Amlodipine is a useful new calcium antagonist for the treatment of hypertension producing smooth, dose‐dependent blood pressure reductions with convenient once daily dosing.
Bartter's syndrome—treatment with potassium, spironolactone and ACE‐inhibitor
Authors: CLEMENTSEN P. , HØEGHOLM A. , HANSEN C. LÆRKHOLM , DAMKJÆR M. , CHRISTENSEN P. , GIESE J.
Published: August 2009

Abstract. The treatment of Bartter's syndrome is fraught with difficulties, and there is no consensus concerning the pathogenetic mechanisms involved. Potassium depletion with hypokaliaemia is a dominant feature of the syndrome. In this case history, a 42‐year‐old woman suffering from Bartter's syndrome did not improve on several therapeutic trials. An impressive progress was noted, however, after intensive potassium repletion with subsequent potassium/spironolactone/ACE‐inhibitor treatment. After 24 months her condition was unchanged with normal and stable Se‐potassium concentration.
Complete occlusion of the left main coronary artery: clinical and angiographic observations in five cases
Authors: SLUNGA L. , ERIKSSON P. , OSTERMAN G.
Published: August 2009

Abstract. Involvement of the left main coronary artery is observed in approximately 5 to 8% of patients with coronary artery lesions detected by coronary angiography, but occlusion of the left main artery is a very infrequent finding. Out of approximately 4000 patients undergoing coronary angiography, four men and one woman, 37 to 60 years old, showed total occlusion of this vessel. Four of them had angina pectoris and three had had a myocardial infarction. All five showed deep ST depression in V2(or 3)‐6 during bicycle exercise testing. Apart from the left main artery occlusion, all had significant obstructive lesions in other coronary vessels, including the right coronary artery or its major branches. There was collateral circulation from the right coronary artery in all patients. Left ventricular function was well preserved in three patients and markedly impaired in two. Four patients underwent bypass surgery and they have been followed for 10 to 28 months. Three are free of angina and one has only minimal angina. One patient refused surgery and he continued to have severe angina despite intense medical treatment. He died suddenly after 30 months follow‐up.

In patients with complete occlusion of the left main coronary artery, development of adequate collateral flow seems important in preserving left ventricular function, but collaterals are usually insufficient to prevent angina. Moreover, associated obstructive lesions in other coronary arteries constitute a potential threat to the collateral circulation. Effective symptomatic relief is obtained by coronary bypass grafting, and revascularization may also improve prognosis in this subset of patients with coronary heart disease.
Advanced cardiac life support in the prehospital setting: the Reykjavik experience
Authors: EINARSSON O. , JAKOBSSON F. , SIGURDSSON G.
Published: August 2009

Abstract. Since 1982 a mobile emergency care unit (emergency ambulance) manned by a physician has been operated in Reykjavik. During 1982–1986 there were 138 attempted resuscitations in sudden cardiorespiratory arrest from cardiac causes. Twenty‐four patients (17%) were discharged home, all but one without mental impairment. Seventy‐three patients presented with ventricular fibrillation, 21 (29%) of which were discharged. The mean ambulance response time was 5 min. Bystanders initiated cardiopulmonary resuscitation (CPR) in 40 cases (29%) which significantly improved the outcome. In witnessed arrests, 19 of 36 patients (53%) with bystander‐initiated CPR were discharged compared to 5 of 62 patients (8%) where CPR awaited the arrival of the ambulance team. These results are comparable to those obtained in larger metropolitan areas. In small urban areas the size of Reykjavik (population of 110000), an advanced and efficient prehospital care can be organized as an extension of the emergency departments role.
Risk factors for cardiovascular disease in 16–19‐year‐old teenagers
Authors: ANDERSEN L. B. , HENCKEL P. , SALTIN B.
Published: August 2009

Abstract. In a representative sample of Danish school children (124 boys and 169 girls), 16–19 years of age, blood pressure, blood lipids, body fat content, maximal aerobic power. alcohol consumption and smoking habits were studied. No systematic variation was noticed within this age in the risk factor profile. The mean values for blood pressure (BP) (systolic/diastolic) were 125/73 mmHg for the boys and 117/71 mmHg for the girls. As much as 14% of the boys and 5% of the girls had either a systolic BP above 140 mmHg or a diastolic BP above 90 mmHg. Total serum cholesterol averaged 4.13 mmol l−1 for the boys and 4.53 mmol l1 for the girls, which is also high compared with adolescents from other countries. The ratios for high density lipoprotein cholesterol to total serum cholesterol were normal and in the range of 0.25–0.28 for both sexes. Other factors associated with coronary heart disease in adults, such as body fat content, serum triglycerides, physical activity, as well as smoking and alcohol habits were similar to that reported for teenagers in other countries. No correlation was found between aerobic power (ml min−1.kg−1) and the risk factors measured.
The relationship between casual and ambulatory blood pressure in essential hypertension: the influence of work, duration of hypertension and antihypertensive treatment
Authors: EISKJÆR H. , PEDERSEN E. B.
Published: August 2009

Abstract. Casual blood pressure (BP) and ambulatory BP (mean 24‐h BP) were determined in 23 untreated patients with essential hypertension and in 11 normotensive healthy control subjects. Mean 24‐h BP was significantly lower than casual BP in patients with essential hypertension, but not in control subjects. This was demonstrated in the patients who did not work during the ambulatory BP monitoring and in the patients with newly recognized hypertension, whereas no differences were revealed either in the patients who went to work or had a known duration of hypertension longer than 6 months. The size of the difference between casual BP and mean 24‐h BP was unaffected by antihypertensive therapy with metoprolol and also individually reproducible. An accordance between casual and ambulatory BP measurements in evaluation of the efficacy of antihypertensive treatment was found in 75% of the patients. Casual BP and mean 24‐h BP were weakly correlated both before and during antihypertensive treatment. It is concluded that the higher casual BP than ambulatory BP in essential hypertension may be a specific characteristic of the disease. Both work and known duration of hypertension longer than 6 months eliminate the difference between casual and ambulatory BP in essential hypertension. Ambulatory BP monitoring seems to be superior to casual BP measurements in the evaluation of antihypertensive treatment.
Changes in serum phosphate during β‐blockade in healthy men are not due to changes in the renal handling of phosphate
Authors: KAYSER L. , PERRILD H. , JØRGENSEN B. , FOGH‐ANDERSEN N. , HANSEN J. E. MØLHOLM
Published: August 2009

Abstract. Serum parathyroid hormone (PTH), phosphate, ionized calcium, magnesium, alkaline phosphatase and creatinine and the urinary excretion of phosphate and creatinine were studied after 1 and 3 weeks β‐blockade in 32 young healthy men given either atenolol at 50 mg. metoprolol at 100 mg, propranolol at 80 mg or placebo twice a day.

After 1 week treatment serum phosphate (mean (range)) increased in the propranolol‐treated subjects (1.17 (0.99–1.30) to 1.32 (1.08–1.71) mmol l−1 (P = 0.03), minor changes were found in the atenolol and the metoprolol‐treated subjects but not in the placebo group. Serum phosphate was unchanged compared to pretreatment values after 3 weeks. Renal clearance and urinary excretion of phosphate and creatinine was unchanged after both 1 and 3‐weeks treatment.

Serum PTH, ionized calcium, magnesium and alkaline phosphatase were unchanged in all groups, whereas serum urate and creatinine increased in the metoprolol‐treated subjects after both 1 and 3 weeks.
Giant cell arteritis: loss of vision during corticosteroid therapy
Authors: FAARVANG K. L. , THYSSEN E. PONTOPPIDAN
Published: August 2009

Abstract.The case of a patient suffering from giant cell arteritis, with loss of vision after about 60 d of steroid treatment, is reported. No other clinical or biochemical signs of active disease were observed. The aetiology of the vascular occlusion is discussed briefly.
Changes of activated partial thromboplastin time during constant intravenous and fixed intermittent subcutaneous administration of heparin
Authors: FAGRELL B. , ARVER S. , INTAGLIETTA M. , TSAI A. G.
Published: August 2009

Abstract. Marked circadian variations in the activated partial thromboplastin time (APTt) during continuous heparin infusions for thromboembolic episodes have been reported in a French study. The aim of the present study was to test if these variations could be reproduced in a Swedish population. The frequency spectrum variations in APTt values were analysed with the Prony and the statistical Pearson product momentum correlation coefficient methods. In seven patients with pulmonary embolism, APTt was checked every fourth hour during 48 h of continuous, constant heparin treatment. In only one patient was a distinct circadian variation of APTt values seen. In six patients with venous leg thromboses, treated with s.c. heparin, marked variations in APTt were noticed over periods of 12 h. These variations paralleled the regular s.c. injections of heparin every twelfth hour. The results of the present study could not confirm the marked circadian variations in APTt reported in an earlier French study during continuous heparin infusions, except in one patient.
Serum levels of insulin‐like growth factor (IGF) I, II and IGF binding protein in diabetic adolescents treated with continuous subcutaneous insulin infusion
Authors: HALL K. , JOHANSSON B. L. , PÓVOA G. , THALME B.
Published: August 2009

Abstract. IGF‐I and IGF‐II as well as the low molecular type of IGF binding protein (IGFPB) were determined in serum from 11 adolescents with insulin‐dependent diabetes mellitus (IDDM) during a cross‐over study with conventional and continuous subcutaneous insulin infusion (CIT and CSII) therapy. At the onset of the study the mean IGF‐I level, 127 ± 15 ng ml−1, was significantly decreased (P < 0.001) in comparison with age‐matched controls, whereas the mean IGF‐II level, 1024 ± 48 ng ml−1. was increased. A significant correlation (r = 0.70, P < 0.05) was found between IGF‐II and HbA1c levels. The mean morning level of IGFBP, 75 ± 17 ng ml−1, at the onset of the study, was increased threefold above that in age‐matched controls (P < 0.01). There was a significant correlation between IGFBP and blood glucose values (r = 0.66, P < 0.05). During CSII therapy a significant decrease (P < 0.05) of the IGFBP levels was seen in subjects with a decrease in glucose levels, whereas no change was observed in IGF levels.

The findings of elevated IGF‐II and IGFBP levels and correlations between IGFBP and blood glucose concentration as well as IGF‐II and HbA1c levels in adolescents with IDDM indicate that both IGF‐II and IGFBP reflect a deranged metabolism caused by inadequate insulin administration.
Long‐term prognosis of surgical treatment of renovascular hypertension
Authors: VON KNORRING J. , LEPÄNTALO M. , FYHRQUIST F.
Published: August 2009

Abstract. During the period 1974–1986, 71 patients were operated on for renovascular hypertension. Forty‐eight patients had atherosclerotic disease and 23 patients had fibromuscular dysplasia. There was no operative mortality. Fourteen patients died during the follow‐up, 12 of them from cardiovascular causes. The 57 surviving patients were reexamined with a mean follow‐up of 7 years. The relative cumulative 5‐ and 10‐ year survival rates in all patients were 79% and 55%, respectively. At follow‐up, seven (19%) of the atherosclerotic patients were classified as cured, 22 (59%) as improved and eight (22%) as failures. In the patients with fibromuscular dysplasia, 12 (60%) were normotensive without medication, and six (30%) were improved. The relative 5‐year survival rates in these aetiological groups were 73% and 90%, respectively. Only complete cure of hypertension by surgery predicted a good outcome, whereas very similar survival curves were found in the improved and failed groups. This could be due to a higher incidence of target organ changes before surgery in the latter groups. A positive blood pressure response to long‐term converting‐enzyme inhibition correlated well with the response to surgery. Renal venous renin studies correctly predicted long‐term outcome of surgery in 78% of the patients studied, but require careful preparation of the patients and interpretation of results.
Prevalence of femoral atherosclerosis in asymptomatic men with hyperlipoproteinaemia
Authors: RUHN G. , ERIKSON U. , OLSSON A. G.
Published: August 2009

Abstract. Sixty‐two male subjects with primary hyperlipoproteinaemia of type IIA (n = 18), type IIB (n = 18) or type IV (n = 24) underwent femoral arteriography to investigate the degree of atherosclerosis. All except two were free from symptoms of peripheral arterial disease. The presence of atheroma was determined according to a standardized consensus procedure based on visual interpretation. Atherosclerosis were graded by means of a scoring system, whereby an overall atherosclerosis score (OAS) was calculated for each patient, based on four consecutive segments of the femoral artery. Thirteen type IIA (72%), 14 type IIB (78%) and 18 type IV (75%) patients had femoral atherosclerosis, and the mean OAS in the patients with hyperlipoproteinaemia of these types were 0.58, 0.75 and 0.49, respectively, all with a standard error of the mean about 0.05. The atherosclerosis score increased the more distal the arterial segment, being most prevalent in the lower inferior segment. The OAS was higher in patients of above median age, in those with systolic or diastolic blood pressure above the median and in smokers. Multiple stepwise regression analysis showed that low density lipoproteins cholesterol was highly significantly related to OAS among smokers.

In conclusion, femoral atherosclerosis is a prevalent finding in asymptomatic subjects with hyperlipoproteinaemia and could serve as a basis for intervention studies.
Elemental diet: a therapeutic approach in chronic inflammatory bowel disease
Authors: LARSEN P. MUNKHOLM , RASMUSSEN D. , RØNN B. , MUNCK O. , ELMGREEN J. , BINDER V.
Published: August 2009

Abstract. The therapeutic effect of an elemental diet (Pepti 2000®) and blended normal diet (placebo) was investigated in 43 out‐patients with chronic inflammatory bowel disease (IBD); 24 with ulcerative colitis (UC) and 19 with Crohn's disease (CD), in a mild to moderate state of disease activity. A pilot study on healthy volunteers was executed to investigate palatability of the two diets.

The patients were randomized in a double‐blind study to the two diet regimes for 14 d. A simultaneous determination of laboratory data including plasma C3c split product and urinary excretion of 51Cr‐EDTA was carried out together with a careful registration of the clinical symptoms and signs. No significant effect on the stage of clinical activity was seen in CD. A significant effect on clinical activity was obtained in both UC groups. The clinical improvement was primarily due to a decrease in number of bowel movements both in the elemental diet group and in the group of patients on the blended normal diet. The gross appearance of rectal mucosa did not improve during the study period in the Pepti 2000 or in the placebo group. The concentration of complement split products in plasma remained unchanged. 51Cr‐EDTA excretion, as an expression of a leaky bowel mucosa, also remained unchanged. It was concluded that an effect on inflammation could not be demonstrated even if both diets seem to have a beneficial effect on the stage of clinical activity, especially diarrhoea, in patients with UC.
Fatty acid composition of serum lipids in patients with a coronary bypass operation
Authors: MARNIEMI J. , LEHTONEN A. , INBERG M. , NIITTYMÄKI K. , MAATELA J. , ALANEN E. , SEPPÄNEN A.
Published: August 2009

Abstract. The fatty acid composition of serum phospholipids and cholesteryl esters was analysed in 71 male patients with angiographically defined three‐vessel coronary artery disease (CAD) selected for a coronary bypass operation. Their 71 control subjects were matched according to age, sex, smoking, relative weight, and absence of CAD.

The concentrations of fatty acids, 14:0, 16:0 and 16:1 of the serum phospholipids, were significantly (P < 0.01, P < 0.05 and P < 0.01, respectively) higher in CAD patients than in the controls. On the other hand, linoleic (18:2Ω6), linolenic (18:3Ω3) and arachidonic (20:4Ω6) acids were at a significantly lower level in the patients when compared to the controls. The polyunsaturated/saturated fatty acids (P/S) ratio in serum phospholipids was significantly (P < 0.01) lower in the patients than in the controls. In the cholesteryl ester fraction the results paralleled those of the phospholipids. Significant correlations were obtained between the polyunsaturated fatty acids and the high density lipoprotein cholesterol or apolipoprotein A‐I in the control subjects but most of these correlations were absent in the patients.

Our present results further support the importance of linoleic acid in the protection against atherosclerosis. However, no unequivocal evidence on the possible beneficial effect of long‐chain Ω3‐fatty acids in comparison with Ω6‐acids was obtained.
Coronary risk factors, development of mycocardial infarction, and plasma oestrogens: a prospective casecontrol study in men
Authors: ELDRUP E. , WINKEL P. , LINDHOLM J. , BENTZON M. W. , JENSEN G. , SCHNOHR P.
Published: August 2009

Abstract. A number of studies have reported hyperoestrogenaemia in men surviving an acute myocardial infarction (AMI). This has led to speculations that hyperoestrogenaemia might be a coronary risk factor. It is not clear why plasma levels of oestrogens should be elevated in coronary heart disease. To ascertain whether hyperoestrogenaemia might be present before the onset of a myocardial infarction, we performed a prospective study in 252 men above the age of forty who within the following 5 years suffered an AMI and, as controls, 526 men matched for age and coronary risk factors and 329 randomly selected men. Mean plasma concentrations of oestradiol and oestrone did not differ significantly between the groups. This suggests that hyperoestrogenaemia is not a coronary risk factor and thus, if present after the AMI, is more likely develop concurrently with the myocardial infarction.
The course of atherosclerotic diseases after carotid endarterectomy in 279 patients followed‐up for 21 years
Authors: SALENIUS J. P.
Published: August 2009

Abstract. Two hundred and seventy‐nine patients underwent 331 consecutive carotid endarterectomies during a 20‐year period from 1965 to 1984 and were followed‐up for 21 years (median 76.0 months). The procedure‐combined mortality was 3.9% (13 out of 331 patients). The mortality was 2–3% during the first 3 years, 4–6% from the fourth to the seventh year, and 9–10% per year thereafter. Late deaths (n = 101) were caused by coronary heart disease (CHD) in 51% by cerebrovascular disease (CVD) in 17% and by other causes in 32% of the cases. The ratio of CHD to CVD deaths, 3:1, is similar to a normal population. The possibility of dying in a cerebrovascular accident is six‐fold in untreated patients when compared to the results in this study. The combined incidence of fatal and non‐fatal strokes during the first and fifth year was 3%, and otherwise 1–2%. The other manifestations of atherosclerosis, CHD, and peripheral arterial occlusive disease were combined with CVD in 68.5% of the cases. The frequency of CHD was significantly combined with elevated serum triglyceride, and apolipoprotein B concentrations, decreased serum high density lipoprotein cholesterol concentrations at the control examination, and frequency of hypertension. Therefore, it would be important to follow such patients and reduce the risk factors of CHD.
Prevalence of benign oesophageal disease in the Danish population with special reference to pulmonary disease
Authors: ANDERSEN L. I. , JENSEN G.
Published: August 2009

Abstract.A population sample, selected at random after stratification for the presence of pulmonary disease, was examined for benign oesophageal disease by means of a mailed questionnaire, which has been described in a previous report.

Eight hundred and nine subjects without pulmonary disease, 264 with chronic bronchitis, and 248 with bronchial asthma answered the questionnaire. Subjects answering affirmatively to a discriminating combination of questions, as well as some of the participants with single symptoms and randomly selected controls without oesophageal symptoms, were invited to a clinical examination (n= 346). One hundred and seventy‐five subjects accepted an invasive investigation, 86 without pulmonary disease and 89 with chronic obstructive pulmonary disease (COPD). Endoscopy of the upper gastrointestinal tract was performed in 169 subjects, while 168 underwent pressure measurements of the oesophagus, and 113 had oesophageal 12‐h pH measurements taken.

On the basis of accepted definitions we found 114 subjects with benign oesophageal disease. The diagnostic sensitivity and specificity of the discriminating combination in the non‐COPD and COPD groups were 73.9%/42.9% and 89.5%/47.1% respectively. The predictive accuracy of the questionnaire in the non‐COPD and COPD group was 0.41 and 0.56, respectively. Prevalence rates of benign oesophageal disease in the non‐COPD and the COPD groups were 34.5% (20–49%) and 44.5% (34–55%) respectively (P< 0.001). We estimated the prevalence rate in the general population to be about 30%.
The development of AIDS or AIDS‐related conditions in a cohort of HIV antibody‐positive homosexual men during a 3‐year follow‐up period
Authors: PEDERSEN C. , KOLBY P. , SINDRUP J. , GAUB J. , ULLMAN S. , GERSTOFT J. , LINDHARDT B. Ø. , DICKMEISS E.
Published: August 2009

Abstract. One hundred and thirty‐three homosexual men seropositive for the antibody against human immunodeficiency virus (HIV) were enrolled in a prospective study in 1984–85. The 3‐year cumulative incidences of the acquired immunodeficiency syndrome (AIDS) and AIDS‐related conditions, by life‐table analyses, were 18% and 34%. The cumulative incidence of immune deficiency defined as CD4 lymphocytes < 0.5 times 109 l−1 was 70% at 3 years. Absence of antibodies to p24 antigen, HIV antigenaemia, CD4 lymphocytes < 0.3 times 10 l−1 and elevated serum level of IgA were significantly associated with the development of AIDS. There was no association between disease progression and persistent generalized lymphadenopathy.

When adjusted to the probable year of infection, these results are in accordance with previous cohort studies. It is concluded that most, or all, subjects seropositive for HIV will develop progressive loss of CD4 lymphocytes followed by clinical signs of immune deficiency, and that differences among previous cohorts with respect to disease progression are probably due to differences in the duration of infection.
Experimental and immunohistochemical studies on the possible role of parathyroid hormone in uraemic pruritus
Authors: STÅHLE‐BÅCKDAHL M. , HÄGERMARK Ö. , LINS L.‐E. , TÖRRING O. , HILLIGES M. , JOHANSSON O.
Published: August 2009

Abstract. Secondary hyperparathyroidism has been suggested as a cause of itching in chronic renal failure. The aim of the present study was to evaluate the possible role of parathyroid hormone (PTH) in pruritus affecting patients undergoing maintenance haemodialysis. In agreement with our previous findings, patients with pruritus had significantly (P < 0.01) higher serum levels of PTH fragment 53–68 (m‐PTH53–68) than patients without pruritus, 47.7±40.0 and 23.4±17.1 μg l−1 respectively. Serum concentrations of other substances including calcium, phosphate and magnesium did not differ between the two groups of patients. Intradermal injections of human PTH1–34 and PTH44–68 failed to evoke any acute or delayed cutaneous reactions in either patients or controls. Immunohistochemical investigations of skin biopsies from uraemic patients using several different antibodies against PTH were negative. Thus, the present results do not support PTH as a peripheral mediator of uraemic itching.
Frequency of alcohol use and the level of education
Authors: JACOBSEN B. K.
Published: August 2009

Abstract. The relationships between the length of education and the frequency of alcohol use were analysed in 12 000 men and women in Tromsø, Norway. Men drank beer and spirits more often than women, whereas the proportion of men and women who drank wine once a week, or more frequently, was the same (9%). Subjects with a high level of education drank all three types of alcohol more frequently than men and women with a low level of education. This was particularly true for wine (and beer for women). About 1% of men and women with less than 8 years of education stated that they drank wine at least once a week. In contrast, about one in four with more than 16 years of education drank wine weekly. The proportion of weekly beer drinkers in men with less than 8 years of education (23%) was less than half that for men with more than 16 years of education (53%). The relationship between the frequency of alcohol use and the level of education was not as strong for spirits as for wine.
Resuscitation of hospitalized patients
Authors: JAKOBSSON J. , DAHLQVIST M. , REHNQVIST N.
Published: August 2009

Abstract. Effects of in‐hospital resuscitations performed by a trained resuscitation team were studied over a 20‐month period during which 1653 deaths were registered. Resuscitative attempts were made in 61 patients with a mean age of 71 years (range 0–86 years). The underlying disease was ischaemic heart disease in 38 cases and most arrests occurred in general wards. Twenty‐one patients were initially resuscitated; 12, however, died after an average of 3.2 days while still in hospital. Nine patients were discharged and seven are still alive after two and a half years.
Effects of acupuncture in moderate, stable angina pectoris: a controlled study
Authors: BALLEGAARD S. , PEDERSEN F. , PIETERSEN A. , NISSEN V. H. , OLSEN N. V.
Published: August 2009

Abstract. In order to evaluate the effects of acupuncture in moderate, stable angina pectoris, 49 patients were randomized to either genuine or sham acupuncture. In sham acupuncture needles were inserted into points within the same spinal segment as in genuine acupuncture, but outside the Chinese meridian system. The effect was evaluated from exercise tests, anginal attack rate and nitroglycerin consumption. There were no significant differences between the effects of genuine and sham acupuncture either on exercise test variables or on subjective variables. In patients receiving genuine acupuncture there was a significant increase in exercise tolerance (median 9%) and in delay of onset to pain (median 10%). No significant changes were observed in patients receiving sham acupuncture. Within both groups there was a median reduction of 50% in anginal attack rate and nitroglycerin consumption, and there was no significant difference between the results achieved in the two groups. It is concluded that with the present design it was not possible to demonstrate any significant differences between the effect of genuine and sham acupuncture.
Metabolic effects of controlled‐release metoprolol in hypertensive men with impaired or diabetic glucose tolerance: a comparison with atenolol
Authors: FAGERBERG B. , BERGLUND A. , HOLME E. , WILHELMSEN L. , ELMFELDT D.
Published: August 2009

Abstract. In a double‐blind, randomized, cross‐over study with a single‐blind placebo run‐in period a new controlled‐release (CR) formulation of metoprolol 200 mg once daily was compared with atenolol tablets 100 mg once daily in 22 patients (age 60.9 ± 0.93 (SE) years) with primary hypertension and impaired or diabetic glucose tolerance. Each period lasted for three weeks.

The two agents produced similar blood pressure 3 h as well as 24 h after drug intake. Three hours after drug intake, heart rate was lower on atenolol than metoprolol CR treatment, indicating a higher degree of β‐receptor blockade for atenolol at this point in time, when the plasma concentration of atenolol was most likely to be close to its peak.

Concentrations of blood glucose, serum insulin, and serum C‐peptide in the fasting state or after an oral glucose load did not differ between the active agents. HbA1c was marginally, but significantly, lower on atenolol than metoprolol CR treatment. No differences were found in serum levels of total, low density lipoprotein (LDL), and high density lipoprotein (HDL) cholesterol or apoA‐I, and apoB lipoproteins or triglycerides. In comparison to the placebo run‐in period, both agents showed an unexpected improvement in glucose tolerance, a decrease in HDL cholesterol and for metoprolol CR a small, but significant decrease in LDL cholesterol.

Thus, treatment with metoprolol CR tablets producing even plasma levels without high peak concentrations and conventional atenolol treatment had similar effects on metabolic control in hypertensive men and abnormal glucose tolerance.
Hand handicap and rheumatoid arthritis in a fish‐eating society (the Faroe Islands)
Authors: RECHT L. , HELIN P. , RASMUSSEN J. O. , JACOBSEN J. , LITHMAN T. , SCHERSTÉN B.
Published: August 2009

Abstract. In the county of Klaksvik, the Faroes, a simple hand test was used for screening all inhabitants between the ages of 40 and 74 years. With its high sensitivity and specificity it revealed a diagnostic panorama entirely different from that seen in previous investigations in other nordic countries.

In Klaksvik the prevalence of hand handicap was about 40%, which is due to the high incidence of osteoarthrosis. The prevalence of rheumatoid arthritis was 1.1%. The high functional capacity and the lower occurrence of rheumatic nodules and erosions found in the patients with rheumatoid arthritis as compared with previous studies suggest that the disease takes a milder course in Klaksvik. This should support the hypothesis that RA patients benefit from a diet rich in fish.
Autonomic neuropathy in non‐insulin dependent (type II) diabetes mellitus. Possible influence of obesity
Authors: BERGSTRÖM B. , LILJA B. , ÖSTERLIN S. , SUNDKVIST G.
Published: August 2009

Abstract. To assess the prevalence of autonomic neuropathy (AN) in non‐insulin dependent diabetes mellitus (NIDDM) and its relationships with other diabetic complications, duration of diabetes, and obesity, we evaluated 51 NIDDM patients (age 41–59 years, mean 49 years, duration of diabetes 0–15 years, mean 6.9 years). AN tests included a deep breathing test (E/I ratio) and an orthostatic tilt table test (acceleration and brake indices). AN was prevalent: almost half of the patients showed signs of AN (25 of 51, 49%) and the most frequent disturbance was an impaired E/I ratio (18 of 25; 72%). There were no obvious correlations between AN indices and the duration of diabetes, symptoms of AN, peripheral neuropathy or retinopathy. However, an influence of obesity on AN was suggested. Patients with AN showed a significantly higher BMI than patients without AN (31.0±0.9 vs. 27.5±0.8; P<0.01).
Pancytopenia in systemic lupus erythematosus related to azathioprine
Authors: NOSSENT J. C. , SWAAK A. J. G.
Published: August 2009

Abstract. A patient with systemic lupus erythematosus (SLE) developed pancytopenia when azathioprine (first 2.0 mg kg−1day−1, then 2.5 mg kg−1 day−1) was added to prednisone for active SLE. This unusual toxic effect of azathioprine occurred during the reduction of corticosteroid dosage. After discontinuation of azathioprine, clinical and haematological recovery occurred.
Pravastatin therapy in primary moderate hypercholesterolaemia: changes in metabolism of apolipoprotein B‐containing lipoproteins
Authors: VEGA G. L. , KRAUSS R. M. , GRUNDY S. M.
Published: August 2009

Abstract. This study examined the actions of pravastatin on the metabolism of apolipoprotein B (apo B) in very low‐, intermediate‐, and low‐density lipoproteins (VLDL, IDL, and LDL) in 10 patients with primary moderate hypercholesterolaemia. 131I‐VLDL apo B was used as a tracer, and appearance of label was followed into IDL apo B and LDL apo B. Compared to placebo, pravastatin therapy reduced levels of cholesterol in total plasma, LDL, VLDL, and IDL cholesterol by 25%, 29%, 31%, and 47%, respectively. Pravastatin treatment also significantly decreased concentrations of apo B in LDL, IDL, and VLDL. The drug significantly reduced the mean production rate for VLDL apo B by 40%, and decreased production rates for LDL apo B in eight of 10 patients. In contrast, fractional catabolic rates (FCRs) were not altered significantly in any of the three lipoprotein fractions on pravastatin therapy. Further, pravastatin produced no consistent changes in LDL particle size, composition, or LDL subclass pattern. Thus pravastatin seemingly reduced input rates for all apo B‐containing lipoproteins. Consistent with previous studies, this response was most likely the result of enhanced removal of nascent lipoproteins by increased activity of LDL receptors, although decreased synthesis of apo B in the liver is a possible second action.
Cardiovascular death after radiotherapy for benign bleeding disorders. The Radiumhemmet metropathia cohort 1912–1977
Authors: RYBERG M. , NILSSON B. , PETTERSSON F.
Published: August 2009

Abstract. Of 788 women treated with ionizing irradiation for benign bleeding disorders (metropathia) 308 (39%) died of cardiovascular disease. In a control group, consisting of 1219 women with metropathia who were not irradiated, 257 (21%) cardiovascular deaths occurred. Although the risk of cardiovascular death in the two studied cohorts compared with national death rates was only 0.92 (lower limit 0.82: upper limit 1.03) and 0.88 (lower limit 0.78: upper limit 0.99) respectively, it was found that women irradiated before the menopause (age 50 years) run a higher risk of cardiovascular death than the controls in the same age group and those irradiated after the menopause.
Smoking and metabolic control in patients with insulin‐dependent diabetes mellitus
Authors: LUNDMAN B. M. , ASPLUND K. , NORBERG A.
Published: August 2009

Abstract.Within a defined geographical area, all 192 subjects with insulin‐dependent diabetes of at least 2 years duration and free of diabetic complications were identified: 60 (31%) were smokers. The prevalence of smoking increased significantly with increasing haemoglobin A1elevels (17.5% among subjects with the best metabolic control, 47.5% in those with the worst control). Smoking and non‐smoking diabetic patients did not differ in attitudes towards the disease, psychological well‐being, extent of tedium, frequency of self‐controls of blood glucose or proportion of patients with any sick leave in the preceding 2 years. In a case referent study of 25 matched patients with good or poor metabolic control, exposure to smoking was significantly more common among those with poor control (odds ratio 6.0). Thus there are several lines of evidence that smoking is associated with impaired metabolic control in patients with diabetes.
Haemodilution with medium molecular weight hydroxyethyl starch in patients with peripheral arterial occlusive disease stage IIb
Authors: KIESEWETTER H. , BLUME J. , JUNG F. , SPITZER S. , WENZEL E.
Published: August 2009

Abstract. The basic therapy of peripheral arterial occlusive disease stage IIb, according to Fontaine, is exercise. It should be determined whether a mild hypervolaemic haemodilution with hydroxyethyl starch or Ringer lactate can produce a further increase in walking distance. For this purpose, three groups of 25 patients each were formed. One group exercised three times weekly and the second group, in addition to exercise, underwent a mild hypervolaemic to isovolaemic dilution therapy with HES for a period of 6 weeks. In the final group the haematocrit was reduced to the same extent by venesections and volume substitution using Ringer lactate. The walking distance in the HES group increased from 216 m to 311 m (44%), in the Ringer lactate group from 214 m to 258 m (20%), and in the exercise group from 213 m to 242 m (14%). On comparison of the groups, the increase in pain‐free walking distance in the HES group differs significantly (P < 0.05) from that achieved in the other groups. It was demonstrated that haemodilution with HES in combination with exercise brings about a clinical effect three times that achieved by exercise alone. Venesection with subsequent administration of Ringer lactate and exercise is superior to exercise alone but markedly inferior to the combination therapy with HES.
Asthma and heterozygous α1‐antichymotrypsin deficiency: a possible association
Authors: LINDMARK B.
Published: August 2009

Abstract. During studies of families with α1‐antichymotrypsin deficiency heterozygotes, an apparently increased prevalence of asthma among first degree relatives was noticed.

In a case control study, the prevalence of asthma among first degree relatives of 12 women with heterozygous α1‐antichymotrypsin deficiency was compared with that of first degree relatives of 58 matched controls. Secondly, the strength of association between asthma and low or subnormal plasma ACT concentration, in first and second degree relatives to heterozygotes, was assessed.

The prevalence of asthma among first degree relatives of women with heterozygous α1‐antichymotrypsin deficiency was significantly higher [prevalence ratio 3.22 (1.06–9.83), P = 0.04]. Among heterozygotes, the prevalence of asthma in first and second degree relatives with low plasma α1‐antichymotrypsin concentration was higher than in relatives with normal plasma ACT concentration, but the difference in prevalence did not reach statistical significance [prevalence ratio 3.1 (0.96–9.83), P = 0.059].

The findings are in agreement with previous studies and suggest a possible association between asthma and heterozygous α1‐antichymotrypsin deficiency.
The effect of captopril and metoprolol as monotherapy or combined with bendroflumethiazide on blood lipids
Authors: FOSS O. P. , JENSEN E. KEHN
Published: August 2009

Abstract. In a 24‐week randomized multicentre single‐blind study, including mild to moderate hypertensives free from other diseases, the effect on blood lipids of captopril (n = 51) was studied and compared with that of metoprolol (n = 53). In order to keep the diastolic pressure < 95 mm Hg, bendroflumethiazide was added to the medication for 11 patients in the captopril group and 11 patients in the metoprolol group. Neither captopril nor metoprolol altered total cholesterol significantly. Captopril as monotherapy increased HDL‐cholesterol by 6.2% (P < 0.01) and decreased triglycerides by 10.6% (P < 0.05). Metoprolol as monotherapy decreased HDL‐cholesterol by 5.6% (P < 0.01) and increased triglycerides by 10.3% (P < 0.05). When bendroflumethiazide was added the favourable effect of captopril on the blood lipids disappeared while the undesirable effect of metoprolol became more pronounced.
Heparin inhibits spontaneous thrombolysis and the thrombolytic effect of both streptokinase and tissue‐type plasminogen activator. An in vitro study of the dislodgement of platelet‐rich thrombi formed from native blood
Authors: GÖRÖG P. , RIDLER C. D. , KOVACS I. B.
Published: August 2009

Abstract. Two in vitro models of coronary thrombolysis in man, i.e. dislodgement of thrombi formed from non‐anticoagulated human blood, either by (i) shear‐stress or (ii) interaction of platelets with type I collagen fibre, were studied. Heparinization (1 U/ml) of blood prior to thrombus formation by (i) strongly inhibited spontaneous dislodgement (P < 0.0001). Heparin (1 U/ml), when added with streptokinase (SK) or tissue‐type plasminogen activator (rt‐PA) prior to thrombus formation, considerably delayed thrombolysis. Furthermore, thrombolysis occurred much earlier when thrombi were perfused with SK or rt‐PA in native than in heparinized blood. Heparin inhibited binding of 125I‐rt‐PA (17%, P < 0.02) and plasminogen (88%, P < 0.0005) to platelets activated by ADP in citrated platelet‐rich plasma. We conclude that heparin interferes with the fibrinolytic system at the surface of activated platelets. Our findings suggest that heparin administration prior to thrombolytic therapy for acute myocardial infarction should be questioned.
Glycosylated haemoglobin (HbA1c) in iron‐ and vitamin B12 deficiency
Authors: GRAM‐HANSEN P. , ERIKSEN J. , MOURITS‐ANDERSEN T. , OLESEN L.
Published: August 2009

Abstract. Glycosylated haemoglobin (HbA1c) was measured in 10 patients with iron deficiency anaemia, 10 patients with vitamin B12 deficiency anaemia and 10 healthy controls. Initially there were no significant differences between the groups (P > 0.4), but after treatment with iron and vitamin B12 for 3 and 6 weeks, the glycosylated haemoglobin concentration decreased significantly (P < 0.01). It was concluded that glycosylated haemoglobin is a sensitive marker of the changes in the erythrocyte population that are observed when predominantly immature erythrocytes are being produced.
Total and age‐specific incidence of Graves' thyrotoxicosis, toxic nodular goitre and solitary toxic adenoma in Malmö 1970–74
Authors: BERGLUND J. , CHRISTENSEN S. BORUP , HALLENGREN B.
Published: August 2009

Abstract. During a 5‐year period, 333 new cases of thyrotoxicosis were diagnosed in a well‐defined urban population of 258 000 inhabitants in southern Sweden without a history of endemic goitre. This corresponds to a mean annual incidence of thyrotoxicosis of 25.8/100000. The incidence of Graves' disease was 17.7, the incidence of toxic nodular goitre was 5.4 and that of solitary toxic adenoma was 2.7/100000/year. The peak age‐specific incidence of Graves' disease was 32.6/100000/year (age group 60–69 years), and that of toxic nodular goitre and solitary toxic adenoma was 31.5/100000/year (age group over 80 years).