bluuebunny/crossref_metadata_2025 huggingface dataset:
A 24‐week Multicenter Double‐blind Study of Doxazosin and Hydrochlorothiazide in Patients with Mild to Moderate Essential Hypertension
Authors: HJORTDAHL PER , VON KROGH HANS , DAAE LUDVIG , HOLME INGAR , HJERMANN INGVAR
Published: August 2010

ABSTRACT. Hjortdahl P, von Krogh H, Daae L, Holme I, Hjermann I (Department of General Practice, University of Oslo, Oslo City Board of Health, Central Laboratory, Life Insurance Companies' Institute for Medical Statistics, Department of Internal Medicine, Ullevaal University Hospital, Oslo, Norway). A 24‐week multicenter double‐blind study of doxazosin and hydrochlorothiazide in patients with mild to moderate essential hypertension.

The new α1‐adrenoceptor antagonist, doxazosin (DOX), was compared with hydrochlorothiazide (HCTZ), both drugs administered once daily, in a randomized double‐blind study including 115 patients. The mean final daily doses used were DOX, 10.8 mg; HCTZ, 89.1 mg. There were no statistically significant differences between treatment groups for blood pressure (BP) changes except that HCTZ produced a significantly greater fall (p=0.04) in supine systolic BP than DOX. The statistically significant mean differences in changes in lipid parameters (total cholesterol and total triglycerides) were in favour of DOX. The number of patients reporting side‐effects were DOX, 27/57; HCTZ, 29/53, with two DOX‐and five HCTZ‐treated patients withdrawn due to side‐effects. In the HCTZ‐treated group, laboratory serum tests indicated 11 patients with abnormally low potassium and seven with abnormally high uric acid concentrations. The overall results suggest a benefit‐to‐risk ratio in favour of DOX.
Trimethoprim Prophylaxis of Acute Exacerbations in Chronic Obstructive Pulmonary Diseases
Authors: LIIPPO KARI , PELLINIEMI TARJATERTTU , LEHTO HEIKKI
Published: August 2010

ABSTRACT. Liippo K, Pelliniemi T‐T, Lehto H (Department of Diseases of the Chest and Haematology, University of Turku, and the Research Center of the Farmos Group Ltd., Turku, Finland). Trimethoprim prophylaxis of acute exacerbations in chronic obstructive pulmonary diseases. Acta Med Scand 1987; 221:455–9.

A double‐blind randomized trial was carried out to study the efficacy and tolerance of trimethoprim with a daily single dose of 300 mg in long‐term prophylaxis of acute exacerbations of chronic obstructive pulmonary diseases (COPD). The patients, 13 in the trimethoprim group and 11 in the placebo group, were followed up at fixed intervals and checked for respiratory functions and haematological parameters for six months. The number of exacerbations were significantly lower than during the previous winter in both groups: 0.6 compared to 3.8 in the trimethoprim group, and 0.6 to 3.0 in the placebo group. Tolerance of trimethoprim was good and did not differ from that of placebo. The necessity of double‐blind trials in evaluating the prophylactic value of antibiotics in COPD is emphasized, since the exacerbations are also dependent on many unknown factors. There were no statistically significant differences in blood counts of folate levels.
Somatic Diseases and Sleep Complaints
Authors: GISLASON THORARINN , ALMQVIST MAGNUS
Published: August 2010

ABSTRACT. Gislason T, Almqvist M (Departments of Lung Medicine and Psychiatry, University Hospital, University of Uppsala, Uppsala, Sweden). Somatic diseases and sleep complaints. An epidemiological study of 3201 Swedish men. Acta Med Scand 1987; 221:475–81.

The prevalence of sleep complaints and somatic diseases was estimated in a random sample of 4064 Swedish men aged 30–69 years. Great difficulty initiating sleep (DIS) was experienced by 6.9% and moderate problems in DIS by 14.3%. Complaints of major difficulty maintaining sleep (DMS) were reported by 7.5% of the men and of moderate DMS by 14.9%. DMS was more frequent with increasing age. Excessive daytime sleepiness (EDS) was reported by 5.7%. Altogether 879 men were attending regular medical examinations for somatic diseases. Among the 299 hypertensive men, major complaints of DMS (13.5%), DIS (8.4%) and EDS (8.8%) were more common, but the 167 men treated with β‐blockers rather showed a proportionally somewhat lower prevalence of sleep complaints. Men with obstructive pulmonary disease (n=113) had a higher prevalence of DMS (18.8%) and EDS (12.4%). Diabetic men (n=74) complained also more often of DMS (21.9%), DIS (21.1%) and EDS (12.2%). Men with rheumatic disease (n=176) and obesity (n=221) also had increased prevalence of sleep complaints.
Prediction of Glomerular Filtration Rate from Serum Creatinine, Age, Sex and Body Weight
Authors: TROLLFORS BIRGER , ALESTIG KJELL , JAGENBURG RUDOLF
Published: August 2010

ABSTRACT. Trollfors B, Alestig K, Jagenburg R (Department of Infectious Diseases, Regional Hospital, University of Umeå, Umeå, and Departments of Infectious Diseases and Clinical Chemistry, Östra Hospital, University of Göteborg, Göteborg, Sweden). Prediction of glomerular filtration rate from serum creatinine, age, sex and body weight. Acta Med Scand 1987; 221:495–8.

The accuracy and precision of estimates of glomerular filtration rate (GFR) from serum creatinine, age, sex and body weight using the methods proposed by Cockroft and Gault and by Siersbaeck‐Nielsen et al. were determined in 234 subjects on 574 occasions. The two methods gave almost identical estimates of GFR. As reference for determination of GFR plasma clearance of 51Cr‐EDTA as described by Bröchner‐Mortensen was used. The estimates of GFR gave a systematic deviation of about 10 ml/min and a precision of about ±15 ml/min (1 SD) in the GFR range between 30 and 90 ml/min.
Early Diagnosis of Acute Myocardial Infarction with a Rapid Latex Agglutination Test for Semi‐quantitative Estimation of Serum Myoglobin
Authors: HANGAARD J. , RASMUSSEN O. , NØRREGAARD‐HANSEN K. , JØRGENSEN N. , SIMONSEN E. E. , NØRGAARD‐PEDERSEN B.
Published: August 2010

ABSTRACT. Hangaard J, Rasmussen O, Nørregaard‐Hansen K, Jørgensen N, Simonsen EE, Nørgaard‐Pedersen B (Department of Internal Medicine, Haderslev Hospital, Haderslev, and Department of Clinical Chemistry, Sønderborg Hospital, Sønderborg, Denmark). Early diagnosis of acute myocardial infarction with a rapid latex agglutination test for semi‐quantitative estimation of serum myoglobin.

A rapid latex agglutination test for the detection of elevated levels of myoglobin in serum was evaluated in a prospective study of 236 patients consecutively admitted to a Coronary Care Unit on suspicion of acute myocardial infarction (AMI). The final diagnosis was made according to the WHO criteria. The prevalence of AMI was 0.45 with a male to female ratio of 2:1. In all patients at least two blood samples were collected with 4 hours interval 4–12 hours after the onset of symptoms. All sera were analysed for myoglobin by a latex agglutination test and by a radioimmunoassay (RIA). The latex test was performed twice, first as an emergency test by the technical assistant on duty and later by another well‐trained technical assistant as her daily routine work. If the latex test was carried out each day by the same well‐trained technical assistant, the test results agreed well with the RIA test results, and the false‐negative fraction for patients with AMI constituted 0.06 and the false‐positive fraction for patients without AMI 0.46. However, when the latex test was performed by the occasional technical assistant on duty, a relatively high degree of discrepancy was observed between the latex test results and the RIA test results, thus giving a false‐negative fraction of 0.11 and a false‐positive one of 0.36. In conclusion, performed under optimal laboratory conditions, the latex test can be used as a reliable method to estimate elevated levels of serum myoglobin. However, used as a bedside emergency examination, the test results correlated rather poorly to the RIA test results, and consequently the latex myoglobin test seems to be of minor clinical importance in the early evaluation of patients with suspected AMI.
A Controlled Study of the Influence of Continuous Subcutaneous Insulin Infusion Treatment on Diabetic Retinopathy during Pregnancy
Authors: LAATIKAINEN LEILA , TERAMO KARI , HIETA‐HEIKURAINEN HELENA , KOIVISTO VEIKKO , PELKONEN RISTO
Published: August 2010

ABSTRACT. Laatikainen L, Teramo K, Hieta‐Heikurainen H, Koivisto V, Pelkonen R (Department of Ophthalmology, I and II Departments of Obstetrics and Gynaecology, III Department of Medicine, Helsinki University Hospital, Helsinki, Finland). A controlled study of the influence of continuous subcutaneous insulin infusion treatment on diabetic retinopathy during pregnancy.

Forty consecutive pregnant patients with insulin‐dependent (Type I) diabetes mellitus were randomized at the end of the first trimester for treatment with conventional insulin therapy (CIT) or continuous subcutaneous insulin infusion therapy (CSII). Nine patients randomized into the CSII group declined the pump treatment. The mean glycosylated haemoglobin (Hb A1c) decreased (p<0.001) both in the CIT and the CSII groups with no difference between the groups. Some deterioration in retinopathy was found in 2/18 patients in the CIT group, in 5/13 in the CSII group, and in 3/9 of those who declined the pump treatment. The proportion of patients whose retinopathy progressed did not differ significantly between the groups, and in the majority the deterioration was mild. However, two patients in the CSII group developed acute ischaemic retinopathy, which progressed to proliferative stage in spite of laser treatment. In these two cases the decrease in the Hb Alc level was among the greatest and fastest in the study. These data suggest that a rapid near normalization of glycaemic control by CSII during pregnancy can accelerate the progress of retinopathy in poorly controlled diabetic patients.
Correlation between Non‐toxic Goitre and Benign Mastopathia
Authors: CHRISTENSEN SVEND BORUP
Published: August 2010

ABSTRACT. Borup Christensen S (Department of Surgery, University of Lund, MalmÖ General Hospital, MalmÖ, Sweden). Correlation between non‐toxic goitre and benign mastopathia. The result of a survey in 477 middle‐aged women.

A survey of thyroid and breast diseases was performed in 477 women representative of a middle‐aged female population in Malmo, Sweden. Fifty‐four women (11.3%) were found to have palpable goitre; 45 of these were unaware of their disorder. All goitres were considered to be benign. One woman with goitre had a mild thyrotoxicosis; the goitres in the other 53 women were atoxic. Seventy‐six women (16.0%) had been subjected to surgical breast biopsy 1–25 years before the present survey (median 9 years). The histological diagnoses were: cancer 1, fibroadenoma 8. cystic disease 48, fibrosis 9, and miscellaneous 10. A correlation between atoxic goitre and histologically verified benign breast disease was found (p<0.05). The correlation was explained solely by an association between goitre and fibrosis of the breast (p<0.001). This study shows a correlation between fibrosis of the breast and atoxic goitre in middle‐aged women. The correlation is considered to be a true one, and a possible explanation is briefly discussed.
Subcortical Arteriosclerotic Encephalopathy (Binswanger's Disease)
Authors: HØJER‐PEDERSEN ELSE , PETERSEN OLE FRITZ
Published: August 2010

ABSTRACT. Højer‐Pedersen E, Petersen OF (Departments of Neurology and Radiology, Odense University Hospital, Odense, Denmark). Subcortical arteriosclerotic encephalopathy (Binswanger's disease). Presentation of two cases.

Subcortical arteriosclerotic encephalopathy (SAE) (Binswanger's disease) was previously diagnosed almost exclusively at autopsy and considered to be very rare. Recent studies, however, indicate that an in vivo diagnosis might be made by means of computed tomography (CT) or nuclear magnetic resonance, resulting in a much more frequent recognition of this chronic encephalopathy of middle‐aged, hypertensive patients. Two cases are presented, in which the clinical and CT findings made a diagnosis of SAE very probable.
Acute Unidentified Hepatitis in a Hypogammaglobulinaemic Patient on Intravenous Gammaglobulin Successfully Treated with Interferon
Authors: LOCKNER DIETER , BRATT GÖRAN , LINDBORG ANNIKA , TÖRNEBOHM EVA
Published: August 2010

ABSTRACT. Lockner D, Bratt G, Lindborg A, TÖrnebohm E (Department of Internal Medicine, Section of Hematology and Oncology, Huddinge University Hospital and Karolinska Institute, Huddinge, Sweden). Acute unidentified hepatitis in a hypogammaglobulinaemic patient on intravenous gammaglobulin successfully treated with interferon.

A 59‐year‐old male with acquired hypogammaglobulinaemia since 1978 developed a fulminant hepatitis. The hepatitis appeared after two years intravenous treatment with Sandoglobu‐lin (Sandoz, Switzerland). No virus markers could be detected in the body fluids or liver tissue. Blood transfusions had not been given within one year before development of the liver disease. There was strong suspicion that the patient had acquired non‐A non‐B hepatitis from the gammaglobulin infusions. Treatment with alpha‐interferon ran parallel to a normalization of the pathological liver enzymes and the histology of the liver. This observation suggests a direct antiviral effect of alpha‐interferon, despite the anecdotical and non‐controlled character of these data.
Problems in Assessing Rationality of Drug Utilization in Less Developed Countries
Authors: ALI HASSAN M.
Published: August 2010

Less developed countries are facing various difficulties in assessing rationality of drug utilization. The problems are essentially related to four major areas; (a) Policies, administration and management, (b) Practice and services, (c) Education and training, (d) Monitoring and research. Drug policies have often failed to recognise the importance of identifying the levels of rationality of the various components of drug utilization. Consequently, neither the need nor the mechanisms to assess rationality were considered. Drug utilization data and records have been poorly developed and maintained, e.g. mal‐managed, inaccurate, and without continuity with regard to collection, monitoring and evaluation. Provision and supply of drugs were handled by an unnecessary multiplicity of departments and state offices, none of which keeping complete records and/or information in relation to needs of drugs nor other health care requirements. Deficiences and shortcomings associated with medical/pharmaceutical practice, services, education and training have as well contributed significantly to the failure of the less developed countries to assess and promote rationality of drug utilization.
Obesity in the Scandinavian Countries: Prevalence and Developmental Trends
Authors: SØRENSEN THORKILD I. A.
Published: August 2010

ABSTRACT In the population of Danish young men, whose height and weight have been measured at the draft boards since 1943, a sudden steep increase occurred after 1960 in the prevalence of severe obesity (body mass index (BMI) ≥31 kg/m2). The increase appeared to be independent of height, homogeneous over the range of severe obesity, unaccompanied by any change in the psychosocial correlates, linked to the birth cohorts, and specific for the severely obese. The cause of the increase in prevalence must be of an environmental nature. Investigation of the developmental course through the school ages and distributional changes over time among school children suggests that the increase in prevalence of severe obesity among young men is due to an increased persistence of obesity through adolescence, which parallels the development of welfare conditions in this country.
Insulin Resistance in Pima Indians
Authors: LILLIOJA S. , BOGARDUS C.
Published: August 2010

ABSTRACT Obesity and diabetes are epidemic in the Pima Indians of Southwest United States. Recent evidence suggests that a reduced metabolic rate may predispose the obesity and, since metabolic rate appears to be familial, this may predispose to the familial dependence of obesity. Obesity is associated with an increased risk of diabetes. Insulin resistance is associated with obesity, but is also familial, independent of obesity. In this population insulin resistance is a risk factor for the development of diabetes. Diabetes occurs when insulin secretory failure is superimposed on insulin resistance. Reduced glucose storage in muscle, regulated by glycogen synthase, is important in determining insulin resistance especially at high plasma insulin concentrations and it is possible that a specific genetic defect may be the cause of this. Obesity has its major effect on insulin action at lower plasma insulin concentrations and we propose that this may in part be due to abnormalities of insulin action induced by an increased fat‐free mass with a consequent enlargement of muscle cells, a reduced capillary supply, and reduced penetration of insulin into muscle in obese subjects. We propose therefore that insulin resistance may be due to a combination of a genetic defect and obesity‐induced changes in the biophysical properties of skeletal muscle. These defects, by slightly increasing the plasma glucose concentration and inducing pancreatic glucose insensitivity, may in turn lead to the development of non‐insulin‐dependent diabetes mellitus.
Genetic Factors in the Regulation of Adipose Tissue Distribution
Authors: BOUCHARD CLAUDE
Published: August 2010

ABSTRACT This paper reviews current data concerning the role of the genotype in human variation in fat distribution and its contribution in regulating fat deposition in various regions of the body, primarily the lower trunk area. After statistical control over age, gender and total amount of subcutaneous fat, one finds an additive genetic effect of about 20–25 % of remaining human variance in amount of lower trunk fat and in the relative proportion of lower trunk versus extremity fat. In spite of such a moderate genetic effect in fat distribution, the preferential site of fat deposition when exposed to chronic overfeeding is largely determined by one's genotype. Characteristics of regional adipose tissue metabolism and morphology are probably involved in mediating some of these genetic effects but other regulatory mechanisms are undoubtedly implicated.
Regional Obesity and Serum Lipids in European Women Born in 1948
Authors: SEIDELL J. C. , CIGOLINI M. , CHARZEWSKA J. , ELLSINGER B. M. , CONTALDO F.
Published: August 2010

ABSTRACT In five different cities in four European countries, women born in 1948 were randomly selected. Anthropometric measurements (i.e. circumferences and skinfolds) were taken. Serum lipids were determined in one laboratory. Different levels of waist circumferences gave different averages and distribution of waist/hip ratio, which confirms the need of precise standardization of these measurements. Women in southern parts of Europe were more overweight than in Northern Europe (partly due to selection bias in Naples) and, when adjusted for that, southern women had a more central distribution of fat (higher waist/thigh, lower triceps/subscapula). When data were pooled, circumference ratios were positively correlated with triglycerides and total cholesterol and negatively with HDL cholesterol. Occupation of husband and body mass index were associated with fat distribution and triglycerides and HDL cholesterol. In multiple regression fat distribution was still correlated with serum lipids but differences in serum lipids between countries did not diminish.
Simplification of Analyses of Fatty Acids in Fish Lipids and Related Lipid Samples
Authors: ACKMAN R. G.
Published: August 2010

ABSTRACT The longer chain, highly unsaturated fatty acids up to 22:6 and typical of fish lipids must be included in many current analyses of fatty acids of diets, blood, and eventually of organ lipids. The use of the GLC liquid phase Carbowax‐20M in a bonded or cross‐linked form, wall‐coated in glass or flexible fused silica capillary columns, eliminates the confusing overlap of component fatty acids of different chain lengths found with polar packed GLC columns. Either isothermal or programmed conditions yield comparable results illustrated with a fish oil analysis.
Comparison of Hydrochlorothiazide and Slow Release Furosemide as Adjuvant Therapy to β‐Blockers in the Treatment of Moderate Hypertension
Authors: HYLANDER BRITTA , DANIELSON MATS , ELIASSON KEITH
Published: August 2010

ABSTRACTFifty hypertensive patients on β‐blocker therapy with supine blood pressure ≤95 mmHg were included in a parallel group, double‐blind study for 12 weeks to compare blood pressures, metabolic and adverse effects of additional treatment with diuretics. Hydrochlorothiazide (HCT) 25 mg daily was added to one group and furosemide 30 mg daily in a slow‐release preparation, Lasix Retard (LR), to the other. Blood pressure decreased significantly and similarly in both groups from about 155/101 to about 144/95 mmHg (p<0.01). Diastolic blood pressure was lowered to ≤90 mmHg in 29% of the HCT patients and in 59% of the LR patients. Serum potassium decreased significantly from 4.05 mmol/l to 3.62 mmol/l on HCT, while the decrease on LR from 4.13 mmol/l to 4.05 mmol/l was not significant. Serum urate increased significantly, although within the normal range, on HCT. No change in fasting blood glucose or HbA1Cwas observed in any pup. The patients were asked to report 40 different possible side‐effects on a visual analogue scale at every visit. The side‐effects already observed on β‐blockers did not change consistently on additional therapy with either HCT or LR. Thus, additional treatment with HCT or LR to patients already treated with β‐blockers results in an equal further blood pressure reduction, but in contrast to treatment with HCT, addition of LR does not affect serum potassium concentrations.
Antibiotic Treatment of Staphylococcus aureus Endocarditis
Authors: FRIMODT‐MØLLER NIELS , ESPERSEN FRANK , ROSDAHL VIBEKE THAMDRUP
Published: August 2010

ABSTRACT Clinical and bacteriological information of Staphylococcus aureus endocarditis was reviewed in 119 cases from all over Denmark. Overall mortality was 71%. Survival correlated with anti‐staphylococcal treatment, short duration from onset of infection to start of treatment, and long duration of treatment. In spite of relevant treatment, mortality was significantly lower in cases infected with penicillin‐susceptible strains than when penicillin‐resistant strains were isolated. There were no differences in the effect of various anti‐staphylococcal treatment regimens; in particular, there were no differences in mortality with regard to beta‐lactam antibiotics alone as compared to beta‐lactam antibiotics in combination with aminoglycosides. However, embolic manifestations occurred more often after start of treatment with combination therapy than with beta‐lactam antibiotics alone.
The Tromsø Heart Study: Is Coffee Drinking an Indicator of a Life Style with High Risk for Ischemic Heart Disease?
Authors: JACOBSEN BJARNE KOSTER , THELLE DAG STEINAR
Published: August 2010

ABSTRACT Associations between coffee drinking, use of table fat with low contents of polyunsaturated fatty acids, preference for low‐fat milk, use of fruits and vegetables, smoking and lack of physical activity in leisure time have been described in a cross‐sectional study of 14582 men and women. Coffee drinking was negatively related to the use of low‐fat milk, use of table fat high in polyunsaturated fatty acids, use of fruits and vegetables, and positively associated with bread consumption. Three persons out of four with high coffee consumption (>8 cups/day) were daily smokers, in contrast to about a quarter of those with low coffee consumption (<1 cup/day). In women and young men, high coffee consumption was associated with low physical activity at leisure. The results suggest that high coffee consumption may be an indicator of a life style with high risk for coronary heart disease.
Plasma and Skeletal Muscle Electrolytes in Patients on Long‐term Diuretic Therapy for Arterial Hypertension and/or Congestive Heart Failure
Authors: DYCKNER THOMAS , WESTER PER OLOV
Published: August 2010

ABSTRACTInvestigations regarding plasma and skeletal muscle electrolytes were carried out in 537 patients on long‐term diuretic treatment (>1 year) for arterial hypertension (n=240) and/or congestive heart failure (n=297). In both groups there were significant decreases in both plasma and skeletal muscle K and Mg, while the muscle Na values as well as the total and extracellular water content of skeletal muscle were increased.
Microalbuminuria in Long‐term Insulin‐dependent Diabetes Mellitus
Authors: BERGLUND JONAS , LINS PER‐ERIC , ADAMSON ULF , LINS LARS‐ERIC
Published: August 2010

ABSTRACT Albumin excretion rate was determined by radioimmunoassay in overnight urine from 102 normotensive patients with insulin‐dependent diabetes mellitus of more than 10 years' duration. Based on two samples, 16 patients (16%) exhibited microalbuminuria, defined as a mean excretion rate >20 μg/min. Microalbuminuric patients were significantly younger at onset of diabetes but did not differ from normoalbuminuric patients concerning age or duration of diabetes. Nonetheless, diastolic and mean arterial blood pressures were significantly higher in the microalbuminuric group. The existing glycemic control, assessed by glycosylated hemoglobin (HbA1C) was better in normoalbuminurics, but not significantly so. The albumin excretion rate in microalbuminuric patients correlated significantly (p<0.01) to diastolic (r=0.69) and to mean arterial blood pressure (r=0.69), but did not correlate to HbA1C. Thus, it is concluded that even normotensive patients with signs of early diabetic nephropathy, i.e. microalbuminuria, exhibit small, but significant increases in blood pressure.
Different Substrate Specificities of Plasma Lecithin: Cholesterol Acyl Transferase in Fish Eye Disease and Tangier Disease
Authors: CARLSON LARS A. , HOLMQUIST LEIF , ASSMANN GERD
Published: August 2010

ABSTRACT Esterification of plasma free cholesterol is mediated by lecithin: cholesterol acyl transferase (LCAT). The free cholesterol of plasma high density lipoproteins (HDL) is considered to be the preferred substrate for LCAT. It therefore appeared as a paradox that plasma cholesterol esterification, both in vivo and in vitro, is normal in fish eye disease and Tangier disease, two familial conditions with extremely low plasma HDL levels. Fish eye disease plasma, however, was shown to have LCAT activity primarily acting on combined very low (VLDL) and low (LDL) density lipoproteins, denominated β‐LCAT, while it lacked LCAT activity esterifying HDL cholesterol (α‐LCAT). Here we show that Tangier plasma, in contrast, has both α‐ and β‐LCAT. Thus, in both fish eye and Tangier diseases it is β‐LCAT that explains the apparent normal plasma cholesterol estenfication. We also show that Tangier plasma, having α‐LCAT activity, normalizes the low cholesteryl ester content as well as the abnormally small size of fish eye disease HDL particles during incubation.
Long‐term ECG Recordings in Thyroxine‐substituted Hypothyroid Subjects
Authors: HYLANDER BRITTA , KENNEBäCK GöRAN , ROSENQVIST URBAN , EDHAG OLOF
Published: August 2010

ABSTRACT. Bradyarrhythmias are sometimes observed in hypothyroid patients. This phenomenon could either be due to the disease process with structural changes of the heart or to an abnormal hormone level. The purpose of the present paper was to study the prevalence of bradyarrhythimas in hypothyroid patients on long‐term substitution therapy. Nineteen subjects were studied 9–53 months after they had reached the final thyroxine substitution level. Ambulatory ECG registrations were performed during 48 hours. Ventricular ectopic beats were observed in 10 of the 19 patients, but no bradyarrhythmias were detected. The results support the notion that arrhythmias found in hypothyroid patients are at least mainly due to the low thyroid hormone level.
Bone Metabolism and Bone Status in Osteoporotic Patients
Authors: HARTWELL DORTHE , RIIS BENTE JUEL , CHRISTIANSEN CLAUS , THOMSEN KARSTEN , JOHANSEN JULIA S. , RøDBRO PAUL
Published: August 2010

ABSTRACT. We have studied bone turnover and bone status in 29 patients with hip fractures and compared them with normal subjects and patients with arthritis of the hip. Markers for bone formation, bone Gla protein, alkaline phosphatase and whole body retention of 99mTc‐diphosphonate, and fasting urinary hydroxyproline, a marker for bone resorption, were all significantly higher in the hip fracture group than in the control group. The serum concentrations of 1,25‐dihydroxyvitamin D were similar in the three groups, whereas the serum 25‐hydroxyvitamin D concentration in the control group was higher than in the patient groups. The bone mineral content (BMC) measured in the distal forearm and the spine was lower than normal in the hip fracture group. We conclude that patients with hip fractures have an increased bone turnover with no signs of bimodality and low BMC values at all locations.
A Re‐examination of Patients with Previously Detected Autoantibodies to Smooth Muscle
Authors: JORDE ROLF , SKOGEN BJøRN , REKVIG OLE P.
Published: August 2010

ABSTRACT. A group of patients which previously had been found to possess smooth muscle antibody (SMA) activity was re‐examined for persistence of the autoantibody. The mean observation time was four years (range 0.5–9 years). Thirty out of 140 patients, who initially had SMA associated with rheumatic or other symptoms, had autoantibody activity at re‐examination. Most were low in titer, and none of the 30 had developed chronic liver disease. Twenty‐four patients with SMA at the first testing were analyzed because of liver pathology. Five had CAH at that time. SMA in low titer associated with liver pathology was a transient phenomenon. SMA in high titer combined with liver pathology seems to be a persistent condition with respect to both parameters, although no additional patients developed CAH between the first testing and re‐examination.
Diagnostic Criteria and Quality Control of the Registration of Stroke Events in the MONICA Project
Authors: ASPLUND K. , TUOMILEHTO J. , STEGMAYR B. , WESTER P.O. , TUNSTALL‐PEDOE H.
Published: August 2010

ABSTRACT. Stroke events are being registered in 27 of the MONICA collaborating centres. Coding of test cases has shown the greatest discrepancies in coding of the type of stroke (different pathoanatomical diagnoses) and of the diagnostic category (whether a definite stroke has occurred or not), 23 % and 14 % discrepancies respectively. A check for completeness of stroke registration at the Northern Sweden MONICA Center showed that more than 91 % of the events were retrieved by routine registration procedures. Measures to reduce the discrepancies in coding between centres and to check for completeness of data are suggested.

In many centres, the number of stroke events below 65 years of age is too small to permit meaningful analyses. By including also stroke events in the 65–74 year age range, the number of fatal events in the Northern Sweden MONICA area increased by 195 % and non‐fatal events by 149 %. Many other MONICA centres have also extended their upper age limit for the registration of stroke events, thus improving the preconditions for statistical evaluations of the long‐term changes in stroke incidence.
Measuring the incidence of acute myocardial infarction: the problem of possible acute myocardial infarction
Authors: MARTIN C.A. , HOBBS M.S.T. , ARMSTRONG B.K.
Published: August 2010

ABSTRACT. Variations in the ratio of »definite» to »possible» myocardial infarction for non‐fatal cases were examined in studies that used World Health Organization criteria. There were large variations in this ratio, variations which appeared to be due to differences in the ascertainment of non‐fatal cases of »possible» myocardial infarction, which, in turn, contributed to reported differences in the incidence of myocardial infarction. A significant proportion of cases of »possible» myocardial infarction probably do not have ischemic heart disease at all, since, in our data, cases of »possible» myocardial infarction (non‐fatal) with a hospital discharge diagnosis of chest pain (undiagnosed) had a risk of death that was no worse than that in the general population. Thus the most reproducible, and possibly most accurate estimates of the incidence of myocardial infarction may come from including only fatal cases of »possible» myocardial infarction with both fatal and non‐fatal cases of »definite» myocardial infarction.
Mortality and coronary events in two Italian MONICA areas: Area Latina and Area Brianza
Authors: GIAMPAOLI S. , MENOTTI A. , CANNATELLI P. , CESANA G.C. , FERRARIO M. , FORTE E. , MAIETTA A. , RIGHETTI G.
Published: August 2010

ABSTRACT. In Italy three areas have been enrolled in the MONICA Project, two being located in Northern Italy (Area Brianza and Area Friuli) and one in Central Italy (Area Latina). This report concerns the comparison of the first year mortality and registration data of two areas, Area Latina (1983) and Area Brianza (1985), for men and women aged 25–64.

In Area Latina, the age‐standardized mortality rates for all causes, for all coronary heart disease, and for stroke are respectively 483, 83 and 42 per 100,000 for males, and 252, 14 and 32 per 100,000 for females. In Area Brianza, the age‐standardized mortality rates for all causes, for all coronary heart disease, and for stroke are respectively 541, 94 and 38 per 100,000 for males, and 249, 19 and 24 per 100,000 for females.

For males the attack rate for coronary events is similar in Area Latina and Area Brianza but the distribution of events in the several diagnostic categories is different. For females the coronary attack rate is higher in Area Latina than in Area Brianza.

The implications of these data are discussed mainly from the methodological point of view.
Mortality, morbidity and case fatality from myocardial infarction and the cardiovascular risk profile in the Warsaw population
Authors: RYWIK S. , KUPŚĆ W. , WĄGROWSKA H. , KULESZA W. , BRODA G. , POLAKOWSKA M.
Published: August 2010

ABSTRACT. The present study, based on the World Health Organization (WHO) MONICA Project design, covers two Warsaw districts inhabited by 274442 people, aged 25–64. In the studied population over the years 1976–1985, no significant time‐trends were found of cardiovascular disease (CVD), ischemic heart disease (IHD), myocardial infarction (MI) and cerebrovascular mortality, whereas the hypertension mortality trends increased significantly.

The MI attack rate in 1984/85 in men aged 25–64 was 466/100.000 and that of women 173/100.000. Within the last 14–15 years the age‐standardized MI attack rates increased by 35 % in men aged 35–64 and by 65 % in women. The 28‐day case fatality was 40 % in men and 35 % in women. Fatality was highest the first day after the onset of symptoms, and only 66 % of men and 72 % of women survived the first 3 days after onset.

No significant differences in age‐standardized mean values of plasma total cholesterol, low‐density lipoprotein (LDL)‐cholesterol and systolic blood pressure (BP) were found between men and women. Mean values of high‐density lipoprotein‐cholesterol (HDL) and of the Quatelet index were higher in the female population, whereas the tryglyceride level, diastolic BP, and the number of cigarettes smoked daily were higher in the male population. In men, the plasma total cholesterol, LDL‐cholesterol and HDL‐cholesterol values did not change with age, but the tryglyceride values decreased; in women, the plasma total cholesterol, LDL‐cholesterol and tryglyceride values increased with age. Mean values of systolic and diastolic BP increased with age in both sexes, whereas the number of cigarettes smoked daily decreased.
A New Water‐soluble, Selective β‐Blocker with Intrinsic Sympathomimetic Activity (ICI 141.292) in Angina Pectoris
Authors: ERIKSSEN JAN , ROLLAG ARNFINN , OTTERSTAD JAN ERIK
Published: August 2010

ABSTRACT In a placebo‐controlled, randomized double‐blind study the effect of ICI 141.292 (β1‐selective β‐blocker with intrinsic sympathomimetic activity = ISA) was studied in 11 patients with severe angina pectoris. The doses used were 100, 200 and 300 mg once daily. The 24‐hour heart rate was significantly reduced by all regimens, and the Holter‐monitoring pattern indicated the presence of ISA‐effect at least 20 hours after the 300‐mg dose. Maximal heart rate and blood pressure were significantly reduced and exercise duration increased during a symptom‐limited bicycle exercise test on 200 and 300 mg, but not on 100 mg daily. Resting heart rate and blood pressure were uninfluenced on all regimens. ICI 141.292 is an effective agent in patients with severe angina pectoris. The response pattern suggests the presence of clinically relevant ISA.
Anti‐anginal Efficacy of a Controlled‐Release Formulation of lsosorbide‐5‐mononitrate Once Daily in Angina Patients on Chronic β‐Blockade
Authors: UUSITALO ARTO , KEYRILÄINEN OLAVI , HÄRKÖNEN RISTO , RAUTIO PENTI , REHNQVIST NINA , ENGVALL JAN , ROSENQVIST ULF , NYBERG GUNNAR , ÅBERG ANDERS , ULVENSTAM GÖRAN , BAE ERLING , BJØRNERHEIM REIDAR , LYNG JOHAN , HALVORSEN FRED‐ARNE
Published: August 2010

ABSTRACTThe anti‐anginal effect of a controlled‐release (Durules®) formulation of isosorbide‐5‐mononitrate (5‐ISMN) 60 mg, Imdur®, once daily was evaluated in a randomised double‐blind, placebo‐controlled, crossover study with a placebo run‐in period. Each period lasted for 2 weeks. A total of 70 patients (58 men and 12 women) with stable exertional angina pectoris on β‐blockade, mean age 59 years (range 39–71), were included. Exercise testing was performed on a bicycle ergometer 3 hours after the dose at the end of each period. Anginal attacks and intake of sublingual nitroglycerin tablets were noted. Imdurr̀ in combination with a β‐blocker significantly increased the total exercise capacity, the time and total work until the onset of chest pain and at 1 mm ST‐depression compared with β‐blockade alone. The attack rate and the nitroglycerin consumption were significantly decreased. Headache was the only significant side‐effect. In conclusion, the addition of Imdur® once daily to β‐blockade significantly increased the anti‐anginal effect.
Coarctation of the Abdominal Aorta in Elderly Patients
Authors: BERGQVIST DAVID , BERGENTZ SVEN‐ERIK , EKBERG MATS , JONSSON KJELL , TAKOLANDER RABBE
Published: August 2010

ABSTRACT Coarctation of the abdominal aorta as a congenital disease is infrequent, the diagnosis mostly being made at an early age because of renovascular hypertension. Patients who reach the age of 40 more often tend to have the problems located distally to the renal arteries. A 66‐year‐old female is described, who developed an aortic occlusion, renovascular hypertension and uremia. She was cured with a bifurcation graft and a patch angioplasty of a stenotic renal artery and nephrectomy of the contralateral kidney with an occluded artery without refilling. A literature survey is made of patients older than 40 years.
A Hyperkinetic Heart in Uncomplicated Active Acromegaly
Authors: THUESEN LEIF , CHRISTENSEN STIG E. , WEEKE JØRGEN , ØRSKOV HANS , HENNINGSEN PER
Published: August 2010

Cardiac function was studied by echocardiography in 12 patients with active acromegaly and in 12 age‐ and sex‐matched healthy control subjects. None of the patients had cardiovascular diseases or other endocrine diseases than acromegaly. The patients had a mean age of 39±5 years and were short‐term acromegalic with a mean duration of disease of 6±3 years. Mean left ventricular mass was 163±43 g/m2 in the acromegalic group versus 120±24 g/m2 in the control group. Preload (the diastolic diameter of the left ventricle) was within normal limits, while afterload (end‐systolic meridional wall stress) was significantly decreased in the acromegalic group. Myocardial contractility assessed as fractional shortening of the left ventricle was 39.9±3.6% in the acromegalic group versus 32.9±5.1% in the control group, and cardiac output was increased by 52% in the acromegalic group because of increased heart rate and stroke volume. We suggest that augmented peripheral blood flow is responsible for the condition of cardiac hyperkinesia in short‐term acromegaly and involved in the development of hypertension, which is a frequent complication of long‐term acromegaly.
Osteoporosis and Back Pain among the Elderly
Authors: FINSEN VILHJALMUR
Published: August 2010

Questionnaire responses from 120 men and 337 women over the age of 50 years were studied to determine the prevalence of back pain among the elderly. In order to gain a rough indication of the back pain among elderly women which might be due to osteoporosis, the prevalence was compared in the two sexes. The prevalence of back pain without radiation to the legs and concomitant morbidity was found to be similar among men and women up to the 70–79‐year age‐group. After this age the prevalence was higher in women. Those with exceptional loss of body height or kyphosis had a high prevalence of back pain, while those who had sustained previous hip or radius fractures did not. There was increasing prevalence of back pain among women with increasing number of previous fractures. The study gives little indication of serious morbidity of osteoporosis in the form of back pain before very old age.
Cyclical Changes in Endogenous Overnight Creatinine Clearance during the Third Trimester of Pregnancy
Authors: PAABY PER , NIELSEN AAGE , MØLLER‐PETERSEN JENS , RAFFN KJELD
Published: August 2010

To investigate the pattern of change in endogenous overnight creatinine clearance during the third trimester, 12 healthy women with uncomplicated pregnancies were examined three times a week. Urine was collected overnight from 22.00 to 08.00 hours and analysed for creatinine. Serum was sampled in the morning and analysed for creatinine, β2‐microglobulin, progesterone and estradiol. The general trend of creatinine clearance was parabolic with a declining level during the last month before term. A sinusoid pattern with minimum values around the time when the women would have had menstruation had they not become pregnant was superimposed on the parabolic trend. A mathematical model (parabolas overlaid with a cosine curve) was constructed and fitted to the data. The cyclical pattern was significant. Serum creatinine showed a pattern with increasing values during the last 4–6 weeks before term and cyclical changes which were also significant. In the individual case the monthly and preterm clearance decrement sometimes was over 50%. Monthly and preterm decreases in creatinine clearance may be quite normal and serial measurements of creatinine clearance are therefore necessary to determine if declining values indicate pathological falls in the glomerular filtration rate.
Unstable Angina Pectoris
Authors: RIDDERVOLD FRIDTJOV , SMISETH OTTO A. , FORFANG KOLBJØRN , FRØYSAKER TOR
Published: August 2010

ABSTRACT One year's experience of an acute revascularization program for unstable angina pectoris is presented. In the total material of 63 patients, significant coronary artery stenosis was found in 61 and normal coronary arteries in two. Coronary artery bypass grafting was performed in 39 patients (62%) and percutaneous transluminal angioplasty in nine (14%). There were two perioperative myocardial infarctions and one hospital death. Thirteen patients were not eligible for revascularization. At follow‐up (14–26 months) 60 patients were still alive (95%). In the revascularization group, one patient had died, but of the remaining 46 patients, 30 (65%) were free of angina pectoris, and in addition six had only minor symptoms.
Mortality and Morbidity During a Five‐year Follow‐up of Diabetics with Myocardial Infarction
Authors: HERLITZ JOHAN , MALMBERG KLAS , KARLSON BJÖRN W. , RYDÉN LARS , HJALMARSON ÅKE
Published: August 2010

ABSTRACT In 787 patients with acute myocardial infarction originally participating in the Göteborg Metoprolol Trial, mortality and morbidity during 5 years' follow‐up were assessed and related to whether patients had diabetes mellitus. Diabetes occurred in 78 patients (10%). Patients with diabetes had a different risk factor pattern, including higher age, higher occurrence of angina pectoris and hypertension, whereas smoking habits did not differ. In the early phase (hospitalization), patients with diabetes had a higher mortality (12% versus 8%), required more treatment for heart failure and stayed longer in hospital. Other morbidity aspects, such as severity of pain, occurrence of severe supraventricular and ventricular arrhythmias, high‐degree AV‐block and infarct size did not differ. During 5 years' follow‐up mortality rate in patients with diabetes mellitus was 55% as compared with 30% among patients with no diabetes (P<0.001). Reinfarction rate during 5 years was 42% in daibetics versus 25% in non‐diabetics (P<0.001). In a multivariate analysis, taking into account the differences in risk factor pattern, diabetes turned out to be an independent determinant for long‐term mortality and reinfarction (P<0.001). We conclude that patients with diabetes mellitus, developing acute myocardial infarction, is a group with particularly high risk of death and reinfarction. Interventions aiming at its reduction have priority.
Pruritus in Patients on Maintenance Hemodialysis
Authors: STÅHLE‐BÄCKDAHL MONA , HÄGERMARK ÖSTEN , LINS LARS‐ERIK
Published: August 2010

ABSTRACT Twenty‐nine patients undergoing maintenance hemodialysis were examined for dermatologic symptoms. Nineteen patients (66%) complained of pruritus, which was classified as mild (34%), moderate (24%), and severe (8%). Patients with pruritus did not differ from those without pruritus regarding serum concentrations of creatinine, urea, calcium, alkaline phosphatase or aluminum, nor was there any difference in duration of hemodialysis, age or sex. In pruritic patients serum concentrations of parathyroid hormone were significantly higher when determined with a mid‐region radioimmunoassay technique (p<0.01) and higher, although not significantly, when the intact parathyroid hormone molecule was measured. Serum concentrations of phosphate were significantly lower in patients with pruritus (p<0.05).
Lipoproteins and Metabolic Control in Hypertensive Type II Diabetics Treated with Clonidine
Authors: NILSSON‐EHLE PETER , EKBERG MATS , FRIDSTRÖM PETER , URSING DAG , LINS LARS‐ERIC
Published: August 2010

ABSTRACT Twenty patients with type II diabetes mellitus and hypertension (WHO stages I and II) participated in a 3‐month double‐blind cross‐over study to evaluate the effects of clonidine (75–300 μg daily) on blood pressure, glycemic control and plasma lipoproteins. Already after 1 month's treatment with clonidine the systolic and diastolic blood pressures had decreased, from 168/103 to 161/98 mmHg (p<0.01). Fasting blood glucose and HbAlc concentrations were unaffected by 3 months' treatment. Similarly, plasma lipid and lipoprotein concentrations remained unchanged throughout the study (i.e. mean high and low density lipoprotein cholesterol concentrations were 0.89 and 3.87 mmol/1 on placebo vs. 0.90 and 3.98 mmol/1 on clonidine). Adverse effects were mild and tolerable, and consisted mainly of dryness of the mouth. We conclude that clonidine lowers the blood pressure in patients with type II diabetes without any adverse effects on glycemic control or plasma lipoproteins.
Inequalities in Chronic Dialysis and Transplantation in Sweden
Authors: KJELLSTRAND CARL M. , TYDÉN GUNNAR
Published: August 2010

ABSTRACT We studied the chance of receiving dialysis and transplantation in Sweden and Stockholm based on age and sex. The number of patients accepted for chronic dialysis, divided into men and women or five age groups, were set in relation to the number of patients who died of ESRD (end‐stage renal disease) in the same groups. The transplanted patients were likewise related to patients waiting on chronic dialysis. Although older patients were increasingly accepted for treatment, age is still strongly inversely correlated to acceptance. Thus in 1985, young patients aged 16–39 years had an 85% chance of being dialyzed, but patients over age 70 had only a 17% chance. Of potential male candidates, 44% received dialysis, but only 38% of women received it. Similar age, but less sex inequality, existed in the selection of patients for transplantation. In Sweden, age and sex influence the selection of patients for dialysis and transplantation.