bluuebunny/crossref_metadata_2025 huggingface dataset:
Pol‐MONICA Cracow On‐Going Study: Initial Findings
Authors: SZNAJD J. , PAJAK A. , MAGDOŃ M. , MISIOWIEC P. , MALCZEWSKA‐MALEC M. , IDZIOR‐WALUŚ B. , CELIŃSKI A. , BACZYŃSKA E.
Published: August 2010

ABSTRACT. The findings after the first year of the study are presented. The study population is 282 052 men and women aged 25–64 years, current residents of rural Tarnobrzeg Voivodeship. The population is characterized by a declining linear trend in ischemic heart disease (IHD) mortality in men aged 35–44 years. The myocardial infarction (MI) incidence (per 100 000 residents) is 233 in men and 68 in women. The MI death rates (per 100 000 residents) are 128 for men and 29 for women. The MI 28‐day case fatality is 44 % for men and 41 % for women. The most frequent risk factors are: smoking in men (58 %) and obesity in women (40 %). Around one‐quarter of the men and of the women are hypertensive. The rates for hypercholesterolemia are 9 % in men and 13 % in women.
Comparison of cardiovascular risk factor levels in two French populations: Haute‐Garonne (Toulouse) and Bas‐Rhin (Strasbourg)
Authors: DOUSTE‐BLAZY Ph. , RUIDAVETS J.B. , ARVEILER D. , BINGHAM A. , CAMARÉ R. , SCHAFFER P. , ABY M.A. , RICHARD J.L.
Published: August 2010

ABSTRACT. Cardiovascular risk factors were studied from 1985 to 1987 in population samples in two French regions with different ischaemic heart disease mortality rates in Bas‐Rhin (Strasbourg MONICA centre) and in Haute‐Garonne (Toulouse MONICA centre). These rates were, among men, 109/100 000 in Bas‐Rhin, and 72/100 000 in Haute‐Garonne. 1 253 and 1 319 men and women aged 35–64 participated in the survey. In each region, identical investigation methodology was used, according to MONICA protocol. The average weight in both sexes was higher in Bas‐Rhin than in Haute‐Garonne (5 Kg more for men and 6 Kg more for women). After adjustment for age, body mass index and tobacco consumption, arterial systolic blood pressure was higher for men in Bas‐Rhin (145 mm Hg) than in Haute‐Garonne (133 mm Hg). Similar differences were observed in women. Higher proportions of hypertensive participants of both sexes and in all age groups were registered in Bas‐Rhin than in Haute‐Garonne. The number of smokers and the amount of tobacco consumption did not differ between the two centres. Mean serum cholesterol was higher in Haute Garonne (5.95 mmol/L for men and 5.88 mmol/L for women) than in Bas‐Rhin (5.57 mmol/L for men and 5.51 mmol/L for women). Also high‐density lipoprotein (HDL)‐cholesterol values were higher in Haute‐Garonne, and can partly explain the regional difference in total cholesterol.
Serum Apolipoproteins, Lipoproteins and Fatty Acids in Relation to Ischaemic Heart Disease in Northern and Southern European Males
Authors: OLSSON ANDERS G. , HOLMQUIST LEIF , WALLDIUS GÖRAN , HÅDELL KARIN , CARLSON LARS A. , RICCARDI GABRIELE , RUBBA PAOLO , PAUCIULLO PAOLO , MANCINI MARIO
Published: August 2010

ABSTRACT Serum apolipoprotein and lipoprotein concentrations, fatty acid spectra of various lipids, dietary habits and common risk factors for ischaemic heart disease were studied in 73 and 77 randomly selected, 50‐year‐old healthy men in Naples and Stockholm, respectively. Mean serum cholesterol concentration was higher in Stockholm than in Naples men (6.23 vs. 5.47 mmol/l, p < 0.001) as were low (LDL) (4.08 vs. 3.57 mmol/l, p < 0.001) and high (HDL) (1.40 vs. 1.25 mmol/l, p < 0.001) density lipoprotein fractions. Mean serum triglyceride concentrations did not differ. Mean apolipoprotein B and C‐I concentrations were higher in Stockholm men (1116 vs. 1020 mg/l, p < 0.05 and 96 vs. 79 mg/l, p < 0.01, respectively). Stockholm men derived significantly more of their calories from fat (38 vs. 28%, p < 0.001) and the dietary fat had significantly lower polyunsaturated‐to‐saturated fatty acid ratio (P/S‐ratio 0.29 vs. 0.51, p < 0.001), and less from carbohydrate (44 vs. 49%, p < 0.001) than Naples men, respectively. Mean caloric intake and mean weight/height index did not differ. Stockholm men had higher blood pressures, but there were more smokers among Naples men. The higher fat intake in Stockholm men may offer an explanation of the differences seen in lipoprotein and apoprotein concentrations and compositions but other factors, such as genetic influences cannot be excluded. A greater cholesterol flux through the plasma compartment in Stockholm men may be one important factor contributing to the higher incidence of ischaemic heart disease in this population.
Chronic Atrial Fibrillation
Authors: LUNDSTRÖM TORBJÖRN , RYDÉN LARS
Published: August 2010

ABSTRACT One hundred consecutive patients admitted in 1980–82 for direct current conversion of chronic atrial fibrillation (AF) were followed. The first attempt to convert was made without the institution of class I antiarrhythmics. If AF relapsed, patients were selected for further conversions, in connection with which quinidine or disopyramide treatment was instituted. The proportion of patients maintaining sinus rhythm (SR) one and two years after the first conversion was 23% and 16%, after the second conversion 40% and 33% and after any number of conversions [1–12] 54% and 41%. Fifty‐three per cent of the patients were symptomless before at least one conversion. Of the patients maintaining SR two years after conversion, 46% did not receive antiarrhythmic therapy. More than two conversions should be exceptional since symptoms of AF are often absent and the additional effect of further conversions is minor. A first attempt to convert without antiarrhythmics identifies a substantial proportion of patients maintaining SR without any prophylactic antiarrhythmic therapy.
Necrotic Bullous Erysipelas
Authors: AGNHOLT JØRGEN , ANDERSEN INGER , SØNDERGAARD GORM
Published: August 2010

ABSTRACT During the last few years streptococcal infections have been reported in connection with various cutaneous manifestations with severe or fatal outcome. A 62‐year‐old female with chronic interstitial nephritis was admitted with progression of confluent bullous lesions on her right leg. She had contracted a superficial scratch on her right foot 2 days prior to admission. Within 16 hours she deteriorated rapidly with symptoms on sepsis. Blood cultures and cutaneous swabs disclosed growth of β‐haemolytic streptococci group A. In spite of correct penicillin treatment she died 28 hours after admission. Skin biopsies from her right leg showed severe necrosis. This report is a reminder that new, cutaneous manifestations of streptococcal disease are still emerging.
Early Heart Failure in the Population
Authors: ERIKSSON HENRY , SVÄRDSUDD KURT , CAIDAHL KENNETH , BJURÖy THORVALD , LARSSON BO , WELIN LENNART , OHLSON LARS‐OLOF , WILHELMSEN LARS
Published: August 2010

ABSTRACT A cross‐sectional analysis of characteristics possibly associated with congestive heart failure (CHF) was performed among 644 men, all 67 years of age and randomly selected from the general population. A total of 13% had symptoms and signs of overt CHF. Another 10% had early or “latent” CHF. Among overt CHF cases, 46% had hypertension, 55% coronary heart disease and 79% any one of these conditions. Among “latent” CHF cases, the corresponding proportions were 52%, 25 % and 65 %. Simple indices of left ventricular diastolic function and filling pressure as well as of pulmonary artery pressure were closer related to the CHF stage, than were measures of systolic left ventricular function. Smoking habits, hypertension, blood lipids, weight and other measures of body fat, blood glucose, and serum insulin were all correlated to CHF stage. In a multivariate analysis, smoking habits, hypertension, body weight, and serum insulin were independently and significantly correlated to CHF stage.
Reduction of Blood Pressure by Treatment with Alphacalcidol
Authors: LIND LARS , LITHELL HANS , SKARFORS EINAR , WIDE LEIF , LJUNGHALL SVERKER
Published: August 2010

ABSTRACTDisturbances of calcium or vitamin D metabolism have been suggested to be of pathogenetic importance both for hypertension and impaired glucose tolerance, two disorders that are commonly associated. In the present study 65 men, aged 61–65 years, with impaired glucose tolerance were enrolled in a prospective, double‐blind, placebo‐controlled study over 12 weeks evaluating the effects of 0.75 μg alphacalcidol, a synthetic analog to the active metabolite of vitamin D. In the 26 patients with blood pressure ≥ 150/90 mmHg before treatment a significant reduction (p< 0.01) of both the systolic (SBP) and diastolic (DBP) blood pressure was found after therapy (from 171/95 to 150/88 mmHg). The effect was additive to concomitant antihypertensive treatment and was correlated (p= 0.03) to a reduction of serum levels of parathyroid hormone. Also in the whole group of patients given alphacalcidol blood pressure was moderately lowered from a mean of 152/87 ± 22/10 (SD) to 143/84 ± 17/8 mmHg. There were no relationships between the changes in body weight, blood glucose or insulin parameters and the changes in blood pressure during the trial. The findings are compatible with the concept that calcium metabolism influences blood pressure regulation and suggest that supplementation with a physiologic dose of active vitamin D could be beneficial for patients with high blood pressure.
Arachidonic Acid Level of Non‐esterified Fatty Acids and Phospholipids in Serum and Heart Muscle of Patients with Fatal Myocardial Infarction
Authors: SKULADOTTIR GUDRUN , BENEDIKTSDOTTIR ELSA , HARDARSON THORDUR , HALLGRIMSSON JONAS , ODDSSON GUDMUNDUR , SIGFUSSON NIKULAS , GUDBJARNASON SIGMUNDUR
Published: August 2010

ABSTRACT The relationship between non‐esterified fatty acids (NEFA) in serum and heart muscle was examined in 15 patients who died of myocardial infarction (MI) and seven people who died suddenly in accidents. There was no correlation between NEFA levels of serum and non‐infarcted cardiac muscle in patients with fatal MI. No significant difference was encountered in cardiac NEFA content between patients with fatal MI and people who died in accidents. The phospholipid (PL) content was significantly lower in patients with fatal MI than observed in people who died in accidents. The arachidonic acid (20: 4 (n‐6)) concentration of serum NEFA was significantly lower in patients with fatal MI compared to normal subjects. The cardiac NEFA and PL in patients with fatal MI contained significantly lower percentage levels of arachidonic acid compared to people who died in accidents. The results indicate that the death of the MI patients was not accompanied by elevated cardiac NEFA levels.
Atrial Natriuretic Peptide during Exercise in Patients with Coronary Heart Disease before and after Single Dose Atenolol and Acebutolol
Authors: KELLER NIELS , SYKULSKI ROMAN , THAMSBORG GORM , STORM TOMMY , LARSEN JOHN
Published: August 2010

Plasma atrial natriuretic peptide (ANP) was measured during dynamic exercise in 10 patients with coronary heart disease before and after single dose atenolol 50 mg and acebutolol 200 mg, respectively. Systolic blood pressure, heart rate and the rate‐pressure product increased during exercise before and after β‐blockade, but levels were lower after β‐blockade. Plasma ANP levels at rest were unchanged after atenolol, but rose after acebutolol (p<0.01). During exercise plasma ANP increased significantly both before and after β‐blockade, but plasma ANP levels were higher after acebutolol at all workloads (p<0.05), whereas plasma ANP levels after atenolol were higher at 125 W exclusively (p<0.05). The augmented ANP levels during exercise after β‐blockade probably reflect catecholamine‐stimulated ANP release, whereas the elevated plasma ANP levels after acebutolol at rest might be a β‐adrenoceptor‐mediated ANP release due to the intrinsic sympathomimetic effect of acebutolol.
Long‐term Results in 64 Patients Operated Upon for Pheochromocytoma
Authors: STENSTRÖM GUNNAR , ERNEST INGRID , TISELL LARS‐ERIK
Published: August 2010

During the years 1956–1982, 64 pheochromocytoma patients were operated upon without mortality. Twenty‐eight patients had sustained hypertension and 29 paroxysmal hypertension only. In two patients high blood pressure was not related to pheochromocytoma and five subjects were normotensive. In two women the pheochromocytoma demonstrated malignancy by widespread metastases. Sixteen patients also had neuroectodermal manifestations other than pheochromocytoma. Preoperatively, heart disease was found in most of the hypertensive patients aged 50 years or more at operation, but was uncommon in the others. In these subjects, heart disease persisted after surgery. Young subjects with sustained hypertension were not less affected by preoperative cerebrovascular accidents than older subjects. After surgery, hypertension persisted in 12 patients, and was easily controlled by drug therapy in eight. Nine patients died 7 months‐18 years after surgery. In no case was the death directly associated with the pheochromocytoma disease. Three died from other neuroectodermal abnormalities. The 55 surviving patients have been followed up for a mean of 12 years after surgery. During the observation time the survival of the pheochromocytoma patients was similar to that of the normal population. At the end of the study, 44 out of the 55 surviving patients were free from symptoms.
Responsiveness to Diving Reflex after Acute Myocardial Infarction: Influence of Early β‐Adrenoceptor Blocker Therapy
Authors: OLSSON GUNNAR , REHNQVIST NINA , EKMAN ANNE‐MARIE
Published: August 2010

We studied the influence of β‐adrenoceptor blockade on heart rate responses to facial immersion in ice‐cooled water after acute myocardial infarction. Forty patients with acute myocardial infarction were randomized to the double‐blind therapy with metoprolol 200 mg daily or matching placebo. Therapy was started as soon as possible after admission to hospital and continued for 15 days. After this initial period all patients were treated with β‐blockade during the subsequent 6 months. Repeated investigations of heart rate responses to facial immersion in ice‐cooled water and 24‐hour ECG‐recordings were performed on day 15 (while patients were on study therapy), after 6 weeks, 3 and 6 months. Throughout the 6‐month period, facial immersion elicited significant heart rate reductions in both treatment groups. No differences were found between the two groups or between different examinations during follow‐up. There was no correlation between heart rate response to facial immersion and frequency of ventricular arrhythmia on a 24‐hour monitoring. In conclusion, acute administration of metoprolol in myocardial infarction does not influence the bradycardial response to facial immersion either in the early postinfarction phase or during 6 months' follow‐up. There is no relation between bradycardial response to face immersion and frequency of ventricular arrhythmias.
One or Three Weeks' Treatment of Acute Pyelonephritis?: A Double‐blind Comparison, Using a Fixed Combination of Pivampicillin Plus Pivmecillinam
Authors: JERNELIUS HANS , ZBORNIK JAN , BAUER CARL‐AXEL
Published: August 2010

The clinical and bacteriological effects of 1 and 3 weeks' pivampicillin plus pivmecillinam treatment were compared in a double‐blind, randomized study of patients with acute pyelonephritis. Three weeks after the end of active treatment, clinical success was seen in 29 (91 %) of the 32 patients on 1‐week treatment, compared with 28 (97%) of the 29 patients treated for 3 weeks. Bacteriological success was seen in only nine (28%) patients in the 1‐week group vs. 20 (69%) in the 3‐week group (p=0.004). This difference was mainly due to a large number of relapses of lower urinary tract infection in the 1‐week group. Even in uncomplicated cases, the bacteriological result of the 1‐week treatment was unsatisfactory. Side‐effects were more common in the 3‐week treatment group. In conclusion, 1‐week treatment of patients with acute pyelonephritis is too short. Three weeks' treatment is effective in uncomplicated cases, but even longer treatment or low‐dose prophylaxis is indicated in certain patients with predisposing factors.
Plasma Atrial Natriuretic Peptide in Cardiac Transplant Recipients
Authors: FORSLUND TERJE , FYHRQUIST FREJ , TIKKANEN ILKKA , FRØYSAKER TOR , MYHRE ERIK , RIDDERVOLD FRIDTJOV , SIMONSEN SVEIN
Published: August 2010

ABSTRACTCardiac transplantation in 10 patients with congestive heart failure resulted in reduction of high plasma concentrations of atrial natriuretic peptide (ANP), preoperatively five‐fold above normal, to a level two‐fold above normal, which was maintained throughout a 12‐week follow‐up period. Cardiac function was normalized in all patients. Transient increases in plasma ANP, in four cardiac recipients 3–10‐fold their basal levels, could neither be related to rejection episodes nor to cardiac dysfunction, but rather to signs of fluid and sodium retention. High plasma ANP levels in cardiac transplant recipients suggest that the capacity to secrete ANP is preserved in the transplanted heart.
Radionuclide Angiocardiography in Post‐myocardial Infarction Patients
Authors: JUUL‐MÖLLER STEEN , LILJA BO , SVENSSON MIKAEL
Published: August 2010

ABSTRACT One hundred and one representative post‐myocardial infarction (MI) patients were investigated with radionuclide angiocardiography (RNA) and exercise test within 1 month of the MI and after 6 and 12 months. From the RNA were calculated the left ventricular ejection fraction (LVEF) and a quantified phase image, the phase standard deviation (phase‐SD), representing the timing of the left ventricular contraction. The mean phase‐SD was significantly higher among these patients (18°, 19° and 18°, respectively, at the three investigations) compared to phase‐SD in normals (6°), indicating an impaired timing of the left ventricular (LV) contraction. At all three investigations a significant correlation was found between the phase‐SD and the LVEF (r=0.58, r=‐0.74 and r=‐0.75, respectively) and the corrected QT interval (r=0.27, r=0.44 and r=0.39, respectively). Maximal serum ASAT in patients with their first MI correlated significantly to phase‐SD. Low exercise capacity or unfavourable NYHA classification was associated with high phase‐SD. Phase‐SD higher than mean was also associated with significantly increased mortality during the follow‐up year (P=0.0057). In conclusion, phase‐SD, reflecting the timing of the LV contraction wave, is easily accessible and clinically relevant. It merits further investigation as a prognostic factor after an MI.
Urinary Prostaglandin E2 and F2α Excretion in Nephrotic Syndrome during Basal Conditions, after Water Loading, and after Remission of the Syndrome
Authors: PEDERSEN ERLING B. , CHRISTENSEN POUL , DANIELSEN HENNING , EISKJæR HANS , JESPERSEN BENTE , LEYSSAC POUL P. , SØRENSEN SØREN S.
Published: August 2010

ABSTRACT The urinary excretion rate of prostaglandin E2 (PGE2) and prostaglandin F2α (PGF2α) was determined in patients with the nephrotic syndrome both before and after an oral water load in 21 patients and 17 control subjects, and before and after remission of the syndrome in 8 of the patients. In the nephrotic syndrome PGE2 excretion rate varied considerably during basal conditions, remission was accompanied by an increase in the PGE2 excretion, and both basal PGF2α excretion rate and the normal response in PGF2α water loading were reduced. A significant, positive correlation was found between urine flow rate and excretion rate of PGE2 in the periods with the largest urine flow rate in both patients and control subjects. It is suggested that a relatively suppressed renal prostaglandin production may be a pathogenetic factor for sodium and water retention in the nephrotic syndrome, although it cannot be excluded that the abnormal prostaglandin excretion pattern is secondary, at least partially, to the reduction of urine flow rate.
Serum Gamma‐glutamyltransferase in a Swedish Female Population
Authors: NYSTRÖM ERNST , BENGTSSON CALLE , LINDSTEDT GÖRAN , LAPIDUS LEIF , LINDQUIST OLOF , WALDENSTRÖM JOHAN
Published: August 2010

ABSTRACT We determined the catalytic concentration of gamma‐glutamyltransferase in serum from a population sample of 1408 women in seven age strata between 26 and 72 years. The range in healthy individuals for the different age groups was found to increase with age with a maximum of the central 0.95 fractile interval at 58 years (0.17‐1.68 μkat/1). The serum gamma‐glutamyltransferase activity correlated with body mass index, blood pressure and concentrations of blood glucose and serum ferritin, triglycerides and cholesterol. During follow‐up of women with gamma‐glutamyltransferase activity >1.20 μkat/1, no woman developed any disease possibly related to the original finding of raised serum gamma‐glutamyltransferase activity, several individuals being apparently healthy. Apparently, the serum gamma‐glutamyltransferase assay is an unspecific indicator of several metabolic abnormalities. High values may be found in individuals in whom all commonly done investigations have given results within the health‐associated reference interval.
Cardiovascular Risk Factors in the Northern Sweden MONICA Study
Authors: HUHTASAARI FRITZ , ASPLUND KJELL , WESTER PER OLOV
Published: August 2010

ABSTRACTIn the WHO MONICA Study, determinants and trends in cardiovascular disease are monitored during a 10‐year period in 40 centers in 27 countries. The Northern Sweden MONICA Center is located furthest to the north of all participating centers. In this report, baseline data on cardiovascular risk factors are presented. In the first population screening, 1625 of 2000 (81%) invited individuals participated. Diastolic blood pressure ≤90 mmHg was recorded in 19% and 9% were on drug treatment for hypertension. Median cholesterol level was 6.10 mmol/1 and the frequency of hypercholesterolemia was high. A body mass index of ≤30, indicating severe obesity, was observed in 9%, a lower proportion than in most other European populations. Among men, the total proportion of tobacco consumers was 49%, including 22% snuffers. Of the women, 31% were tobacco consumers, very few being snuffers. Women had, in general, a more favorable cardiovascular risk factor profile up to the age of 45. Thereafter, the two genders were similar. By international comparisons, the population in northern Sweden is characterized by high serum cholesterol levels, intermediate blood pressure levels, a relatively low prevalence of severe obesity and a high consumption of smokeless tobacco.
Glycaemic Control, Smoking Habits and Diabetes Duration Affect the Extrinsic Fibrinolytic System in Type I Diabetic Patients but Microangiopathy Does Not
Authors: NILSSON TORBJORN K. , LITHNER FOLKE
Published: August 2010

ABSTRACTThe fibrinolytic system was studied in 43 type I diabetic patients with long duration of the disease, with or without evidence of microangiopathy, and in 26 control subjects. There were positive and independent correlations between tissue plasminogen activator (tPA) activity after venous occlusion and HbAlc, and between triglycerides and plasminogen activator inhibitor (PAI‐1) and tPA antigen concentrations before and after venous occlusion. The tPA activities both at rest and after venous occlusion were higher in the patients. There were no differences with regard to sex, hypertension or nephropathy for the levels of fibrinolytic variables in these patients. Subjects with retinopathy did not differ from those without retinopathy. Diabetes duration showed a significant negative association with tPA activity in multivariate regression analysis. Tobacco‐smoking diabetics, as compared to non‐smoking, had an increased tPA antigen release at venous occlusion, but also higher PAI‐1 levels and reduced specific activity of the tPA protein. When assessed with the new specific assays now available, the fibrinolytic parameters appear to be specific indicators of endothelial dysfunction related to smoking and to degree of glycaemic control in type I diabetic subjects.
Non‐operative Inactivation of a Parathyroid Tumour in a Patient with Hypercalcaemic Crisis
Authors: KARSTRUP STEEN , LOHELA PENTTI , APAJA‐SARKKINEN MEERI , BORGMÄSTARS HARRY , HOLOPEINEN OLLI
Published: August 2010

ABSTRACT A parathyroid tumour in a patient with hypercalcaemic crisis was inactivated under con‐tinuous ultrasonic guidance using percutaneous injection of 96% ethanol.
Incidence of Nocturnal Hypoglycaemia in Insulin‐dependent Diabetic Patients on Intensive Therapy
Authors: BENDTSON INGER , KVERNELAND ARNE , PRAMMING STIG , BINDER CHRISTIAN
Published: August 2010

ABSTRACT The frequency of nocturnal hypoglycaemia, i.e. blood glucose concentration (BG) <3.0 mmol/l, was evaluated in consecutively selected insulin‐dependent patients on multiple insulin injections (MII), n =23, or continuous subcutaneous insulin infusions (CSII), n =25. Blood was sampled hourly from 23.00 to 07.00. Seven patients (30%) on MII had at least one BG <3.0 mmol/l during the night. Eleven patients (44%) on CSII had hypoglycaemia (NS). The total number of BGs <3.0 mmol/l was higher on CSII, 42 of 225, versus 16 of 207 on MII (p<0.025). The duration of hypoglycaemia was 2 hours (range 1–6) on MII and 4 hours (range 1–7) on CSII with a maximal prevalence at 4 hours and between 5 and 7 hours, respectively (p=<0.05). The frequency of nocturnal hypoglycaemia is high in patients on intensified insulin regimens. Nocturnal hypoglycaemia occurs later in the night and is of longer duration on CSII than on MIL HbA1c, BG before bedtime and in the morning might be useful in the evaluation of nocturnal hypoglycaemia.
Caffeine Stimulates in vivo Platelet Reactivity
Authors: AMMATURO VINCENZO , PERRICONE CORRADO , CANAZIO ANNA , RIPALDI MIMMO , RUGGIANO ANTONIO , ZUCCARELLI BRUNO , MONTI MARIO
Published: August 2010

ABSTRACT The effect of coffee drinking on platelet reactivity was studied in 12 healthy subjects. Plasma beta‐thromboglobulin concentration was determined before and one hour after administration of 100 mg of caffeine, corresponding to one cup of coffee. Mean values were 47.0±19.3 and 179.3±85.5 ng/ml before and after caffeine administration respectively. The increase, 298±150%, is highly significant (p<0.001).
Assessment of D‐dimer in Plasma: Diagnostic Value in Suspected Deep Venous Thrombosis of the Leg
Authors: OTT PETER , ASTRUP LONE , JENSEN RENE HARTVIG , NYELAND BENTE , PEDERSEN BO
Published: August 2010

ABSTRACT D‐dimer, a fibrin degradation product containing the gamma‐gamma crosslink of fibrin, can now be assayed by the use of highly specific monoclonal antibodies. Such assays are not influenced by fibrinogenolysis and measurements can be performed on citrated plasma. The diagnostic values of four such assays—two based on ELISA technique and two on latex agglutination—were evaluated in 108 out of 118 consecutive patients admitted with suspected deep venous thrombosis of the leg. With cut‐off limits defined by a pilot study and with venography as reference, a negative D‐dimer test was confirmed in 45 of 46 patients (98%; 95% confidence limits: 88–99.9%) after ELISA‐M, in 43 of 44 (98%; 88–99.9%) after ELISA‐S, in 54 of 67 (81%; 69–89%) after Latex‐M and in 40 of 44 (91%; 78–97%) after Latex‐S. A positive D‐dimer test was confirmed in 61% (48–73%), 59% (46–71%), 63% (47–78%), and 55% (42–67%) respectively. These data suggest the use of one of the ELISA assays for screening. A negative D‐dimer test excludes deep venous thrombosis, whereas a positive D‐dimer should be followed by venography. By this procedure a 40% reduction of venographic examinations can be expected.
Adrenal Pheochromocytoma—Ganglioneuroma Producing Catecholamines and Various Neuropeptides
Authors: SALMI JORMA , PELTO‐HUIKKO MARKKU , AUVINEN OSSI , KARVONEN ANNA‐LIISA , SAARISTO JARMO , PARONEN ILKKA , PÖYHÖNEN LAURI , SEPPÄNEN SEPPO
Published: August 2010

Abstract. A 65‐year‐old woman presenting with back pain, difficulties in walking and watery diarrhea. A right adrenal tumor and high excretion of catecholamines were found. Laboratory examinations showed raised levels of vasoactive intestinal polypeptide, pancreatic polypeptide, gastrin and calcitonin. Histology showed a combined pheochromocytoma—ganglioneuroma. The neoplastic cell population was immunohistochemically shown to contain tyrosine hydroxylase, neuropeptide Y, met‐enkephalin, substance P, vasoactive intestinal polypeptide, calcitonin and calcitonin gene‐related peptide. Postoperatively, the patient recovered fully and the hormone levels returned to normal.
Coronary Thrombolysis
Authors: ERHARDT LEIF , EMANUELSSON HÅKAN , HARTFORD MARIANNE , JOHNSSON HANS , STRANDBERG LARS‐ERIK
Published: August 2010

Myocardial infarction (MI) size is the major determinant of the function of the left ventricle and thus of the prognosis of the patient. Attempts to limit infarct size therefore constitute an important goal in modern coronary care. There is evidence that intravenous thrombolytic therapy can lyse coronary artery thrombi, restore antegrade coronary blood flow, preserve myocardial viability and function and improve survival. The time interval from onset of infarction, the extent of remaining ischemic myocardium and the rate at which myocardial necrosis is progressing are factors influencing the extent of myocardial salvage in reperfusion.
Haemorrhagic and Thromboembolic Complications versus Intensity of Treatment of Venous Thromboembolism with Oral Anticoagulants
Authors: SCHULMAN SAM , STIGENDAL LENNART , JANSSON JAN‐HÅKAN , BROHULT JOHAN
Published: August 2010

Abstract. In order to assess the recommended therapeutic interval with the prothrombin complex analysis, using Stago Prothrombin‐complex Assay (SPA) as the reagent, a retrospective multicentre study was performed to obtain clinical documentation. All thromboembolic and haemorrhagic complications during secondary prophylaxis after venous thromboembolism in 272 patients were recorded and related to the intensity of the oral anticoagulation. Six thromboembolic complications in patients without a malignant disease occurred at SPA levels ≥28%, confirming that the limit of the therapeutic range, determined by the risk of thromboembolic recurrences, should be set at an SPA level of 25% (international normalized ratio, INR=2.0), at least in venous disease. Major haemorrhages occurred mainly at SPA levels ≤10% (INR>4.0), unless underlying risk factors were present, thus setting the other limit of the therapeutic range. However, an adjustment of this limit to SPA=15% (INR≅3.0) is suggested, since it would lead to further reduction of haemorrhage and is advisable in most patients with venous thromboembolism.
Tobacco Smoking and Twinning
Authors: OLSEN JØRN , BØNNELYKKE BIRGITTE , NIELSEN JOHANNES
Published: August 2010

Abstract. In a case‐control study an association was found between mothers' smoking habits and the frequency of dizygotic twinning. As cases were included all twins born in Denmark in 1984 and 1985. A random sample of 1.5% of mothers to singletons, born in the same period were selected as controls. Only live‐borns, conceived after no hormonal treatment, were included in the study. The finding may be due to the well‐known anti‐estrogen effect of smoking.
Cytostatic Treatment of Glomerular Diseases. V
Authors: BRAHM M. , BALSLØV J. T. , BRAMMER M. , BRUN C. , GERSTOFT J. , JØRGENSEN H. E. , KAMPER A. , LARSEN S. , LORENZEN I. , THOMSEN Å. C.
Published: August 2010

Abstract. Thirty‐two patients suffering from biopsy‐proven glomerulonephritis with proteinuria ≥1.2 g/24 hours and/or creatinine clearance <50% of normal value were treated for 6 weeks with prednisone plus cyclophosphamide (C+P), azathioprine (A+P) or cyclophosphamide as a monotherapy (C). The effect of the treatment was evaluated after 6 and 16 weeks. The results were entered consecutively in a sequential analysis. The three treatment regimes were compared mutually as well as with the results of 16 weeks' treatment with C and placebo, published previously. Six weeks' treatment with C+P or A+P was superior to C and at least as efficient as 16 weeks' C treatment. C treatment for 6 weeks was less efficient than 16 weeks' C treatment. The side‐effects of the 6 weeks' A+P or C+P treatment were fewer and less serious than those reported from the long‐term C treatment.
Monitoring of intra‐operative nociception: skin conductance and surgical stress index versus stress hormone plasma levels
Authors: Ledowski T. , Pascoe E. , Ang B. , Schmarbeck T. , Clarke M.W. , Fuller C. , Kapoor V.
Published: August 2010

‘Surgical Stress Index’ and the ‘Number of Fluctuations in Skin Conductance.s−1, use different methods to analyse sympathetic tone and so provide an estimate of peri‐operative analgesia. The aim of our study was to investigate the relationship between these methods and stress hormone plasma levels. In 20 patients scheduled for elective surgery, values of the two methods, mean arterial blood pressure, heart rate and blood samples (to measure plasma levels of adrenaline, noradrenaline, adrenocorticotrophic hormone and cortisol) were obtained at five time points. Changes in Surgical Stress Index and the Number of Fluctuations in Skin Conductance.s−1 only partially reflected changes in plasma noradrenaline levels. Surgical Stress Index, heart rate and blood pressure, but not the ‘Number of Fluctuations in Skin Conductance.s−1 changed in response to changes in depth of analgesia by showing significant differences between before and after a bolus of fentanyl. However, the overall predictive ability of both methods was poor.
Landscape influences on genetic differentiation among bull trout populations in a stream‐lake network
Authors: MEEUWIG MICHAEL H. , GUY CHRISTOPHER S. , KALINOWSKI STEVEN T. , FREDENBERG WADE A.
Published: August 2010

This study examined the influence of landscape heterogeneity on genetic differentiation between migratory bull trout (Salvelinus confluentus) populations in Glacier National Park, Montana. An information‐theoretic approach was used to compare different conceptual models of dispersal associated with barriers, different models of isolation by distance, and the combined effects of barriers, waterway distance, patch size, and intra‐ and inter‐drainage distribution of populations on genetic differentiation between bull trout populations. The effect of distance between populations on genetic differentiation was best explained by partitioning the effects of mainstem and tributary stream sections. Models that categorized barriers as having a one‐way effect (i.e. allowed downstream dispersal) or a two‐way effect were best supported. Additionally, patch size and the distribution of populations among drainages influenced genetic differentiation. Genetic differentiation between bull trout populations in Glacier National Park is linked to landscape features that restrict dispersal. However, this analysis illustrates that modelling variability within landscape features, such as dispersal corridors, will benefit landscape genetic analyses. Additionally, the framework used for evaluating the effects of barriers must consider not just barrier presence, but also potential asymmetries in barrier effects with respect to the organism under investigation.
Use of resistance surfaces for landscape genetic studies: considerations for parameterization and analysis
Authors: SPEAR STEPHEN F. , BALKENHOL NIKO , FORTIN MARIE‐JOSÉE , MCRAE BRAD H. , SCRIBNER KIM
Published: August 2010

Measures of genetic structure among individuals or populations collected at different spatial locations across a landscape are commonly used as surrogate measures of functional (i.e. demographic or genetic) connectivity. In order to understand how landscape characteristics influence functional connectivity, resistance surfaces are typically created in a raster GIS environment. These resistance surfaces represent hypothesized relationships between landscape features and gene flow, and are based on underlying biological functions such as relative abundance or movement probabilities in different land cover types. The biggest challenge for calculating resistance surfaces is assignment of resistance values to different landscape features. Here, we first identify study objectives that are consistent with the use of resistance surfaces and critically review the various approaches that have been used to parameterize resistance surfaces and select optimal models in landscape genetics. We then discuss the biological assumptions and considerations that influence analyses using resistance surfaces, such as the relationship between gene flow and dispersal, how habitat suitability may influence animal movement, and how resistance surfaces can be translated into estimates of functional landscape connectivity. Finally, we outline novel approaches for creating optimal resistance surfaces using either simulation or computational methods, as well as alternatives to resistance surfaces (e.g. network and buffered paths). These approaches have the potential to improve landscape genetic analyses, but they also create new challenges. We conclude that no single way of using resistance surfaces is appropriate for every situation. We suggest that researchers carefully consider objectives, important biological assumptions and available parameterization and validation techniques when planning landscape genetic studies.
Landscape genetics: where are we now?
Authors: STORFER ANDREW , MURPHY MELANIE A. , SPEAR STEPHEN F. , HOLDEREGGER ROLF , WAITS LISETTE P.
Published: August 2010

Landscape genetics has seen rapid growth in number of publications since the term was coined in 2003. An extensive literature search from 1998 to 2008 using keywords associated with landscape genetics yielded 655 articles encompassing a vast array of study organisms, study designs and methodology. These publications were screened to identify 174 studies that explicitly incorporated at least one landscape variable with genetic data. We systematically reviewed this set of papers to assess taxonomic and temporal trends in: (i) geographic regions studied; (ii) types of questions addressed; (iii) molecular markers used; (iv) statistical analyses used; and (v) types and nature of spatial data used. Overall, studies have occurred in geographic regions proximal to developed countries and more commonly in terrestrial vs. aquatic habitats. Questions most often focused on effects of barriers and/or landscape variables on gene flow. The most commonly used molecular markers were microsatellites and amplified fragment length polymorphism (AFLPs), with AFLPs used more frequently in plants than animals. Analysis methods were dominated by Mantel and assignment tests. We also assessed differences among journals to evaluate the uniformity of reporting and publication standards. Few studies presented an explicit study design or explicit descriptions of spatial extent. While some landscape variables such as topographic relief affected most species studied, effects were not universal, and some species appeared unaffected by the landscape. Effects of habitat fragmentation were mixed, with some species altering movement paths and others unaffected. Taken together, although some generalities emerged regarding effects of specific landscape variables, results varied, thereby reinforcing the need for species‐specific work. We conclude by: highlighting gaps in knowledge and methodology, providing guidelines to authors and reviewers of landscape genetics studies, and suggesting promising future directions of inquiry.
Modelling functional landscape connectivity from genetic population structure: a new spatially explicit approach
Authors: BRAUNISCH VERONIKA , SEGELBACHER GERNOT , HIRZEL ALEXANDRE H.
Published: August 2010

Functional connectivity between spatially disjoint habitat patches is a key factor for the persistence of species in fragmented landscapes. Modelling landscape connectivity to identify potential dispersal corridors requires information about those landscape features affecting dispersal. Here we present a new approach using spatial and genetic data of a highly fragmented population of capercaillie (Tetrao urogallus) in the Black Forest, Germany, to investigate effects of landscape structure on gene flow and to parameterize a spatially explicit corridor model for conservation purposes. Mantel tests and multiple regressions on distance matrices were employed to detect and quantify the effect of different landscape features on relatedness among individuals, while controlling for the effect of geographic distance. We extrapolated the results to an area‐wide landscape permeability map and developed a new corridor model that incorporates stochasticity in simulating animal movement. The model was evaluated using both a partition of the data previously set apart and independent observation data of dispersing birds. Most land cover variables (such as coniferous forest, forest edges, agricultural land, roads, settlements) and one topographic variable (topographic exposure) were significantly correlated with gene flow. Although inter‐individual relatedness inherently varies greatly and the variance explained by geographic distance and landscape structure was low, the permeability map and the corridor model significantly explained relatedness in the validation data and the spatial distribution of dispersing birds. Thus, landscape structure measurably affected within‐population gene flow in the study area. By converting these effects into spatially explicit information our model enables localizing priority areas for the preservation or restoration of metapopulation connectivity.
Perspectives on the use of landscape genetics to detect genetic adaptive variation in the field
Authors: MANEL STÉPHANIE , JOOST STÉPHANE , EPPERSON BRYAN K. , HOLDEREGGER ROLF , STORFER ANDREW , ROSENBERG MICHAEL S. , SCRIBNER KIM T. , BONIN AURÉLIE , FORTIN MARIE‐JOSÉE
Published: August 2010

Understanding the genetic basis of species adaptation in the context of global change poses one of the greatest challenges of this century. Although we have begun to understand the molecular basis of adaptation in those species for which whole genome sequences are available, the molecular basis of adaptation is still poorly understood for most non‐model species. In this paper, we outline major challenges and future research directions for correlating environmental factors with molecular markers to identify adaptive genetic variation, and point to research gaps in the application of landscape genetics to real‐world problems arising from global change, such as the ability of organisms to adapt over rapid time scales. High throughput sequencing generates vast quantities of molecular data to address the challenge of studying adaptive genetic variation in non‐model species. Here, we suggest that improvements in the sampling design should consider spatial dependence among sampled individuals. Then, we describe available statistical approaches for integrating spatial dependence into landscape analyses of adaptive genetic variation.
Gene movement and genetic association with regional climate gradients in California valley oak (Quercus lobataNée) in the face of climate change
Authors: SORK VICTORIA L. , DAVIS FRANK W. , WESTFALL ROBERT , FLINT ALAN , IKEGAMI MAKIHIKO , WANG HONGFANG , GRIVET DELPHINE
Published: August 2010

Rapid climate change jeopardizes tree populations by shifting current climate zones. To avoid extinction, tree populations must tolerate, adapt, or migrate. Here we investigate geographic patterns of genetic variation in valley oak,Quercus lobataNée, to assess how underlying genetic structure of populations might influence this species’ ability to survive climate change. First, to understand how genetic lineages shape spatial genetic patterns, we examine historical patterns of colonization. Second, we examine the correlation between multivariate nuclear genetic variation and climatic variation. Third, to illustrate how geographic genetic variation could interact with regional patterns of 21st Century climate change, we produce region‐specific bioclimatic distributions of valley oak using Maximum Entropy (MAXENT) models based on downscaled historical (1971–2000) and future (2070–2100) climate grids. Future climatologies are based on a moderate‐high (A2) carbon emission scenario and two different global climate models. Chloroplast markers indicate historical range‐wide connectivity via colonization, especially in the north. Multivariate nuclear genotypes show a strong association with climate variation that provides opportunity for local adaptation to the conditions within their climatic envelope. Comparison of regional current and projected patterns of climate suitability indicates that valley oaks grow in distinctly different climate conditions in different parts of their range. Our models predict widely different regional outcomes from local displacement of a few kilometres to hundreds of kilometres. We conclude that the relative importance of migration, adaptation, and tolerance are likely to vary widely for populations among regions, and that late 21st Century conditions could lead to regional extinctions.
Spatial modelling and landscape‐level approaches for visualizing intra‐specific variation
Authors: THOMASSEN HENRI A. , CHEVIRON ZACHARY A. , FREEDMAN ADAM H. , HARRIGAN RYAN J. , WAYNE ROBERT K. , SMITH THOMAS B.
Published: August 2010

Spatial analytical methods have been used by biologists for decades, but with new modelling approaches and data availability their application is accelerating. While early approaches were purely spatial in nature, it is now possible to explore the underlying causes of spatial heterogeneity of biological variation using a wealth of environmental data, especially from satellite remote sensing. Recent methods can not only make inferences regarding spatial relationships and the causes of spatial heterogeneity, but also create predictive maps of patterns of biological variation under changing environmental conditions. Here, we review the methods involved in making continuous spatial predictions from biological variation using spatial and environmental predictor variables, provide examples of their use and critically evaluate the advantages and limitations. In the final section, we discuss some of the key challenges and opportunities for future work.
Considering spatial and temporal scale in landscape‐genetic studies of gene flow
Authors: ANDERSON COREY DEVIN , EPPERSON BRYAN K. , FORTIN MARIE‐JOSÉE , HOLDEREGGER ROLF , JAMES PATRICK M. A. , ROSENBERG MICHAEL S. , SCRIBNER KIM T. , SPEAR STEPHEN
Published: August 2010

Landscape features exist at multiple spatial and temporal scales, and these naturally affect spatial genetic structure and our ability to make inferences about gene flow. This article discusses how decisions about sampling of genotypes (including choices about analytical methods and genetic markers) should be driven by the scale of spatial genetic structure, the time frame that landscape features have existed in their current state, and all aspects of a species’ life history. Researchers should use caution when making inferences about gene flow, especially when the spatial extent of the study area is limited. The scale of sampling of the landscape introduces different features that may affect gene flow. Sampling grain should be smaller than the average home‐range size or dispersal distance of the study organism and, for raster data, existing research suggests that simplifying the thematic resolution into discrete classes may result in low power to detect effects on gene flow. Therefore, the methods used to characterize the landscape between sampling sites may be a primary determinant for the spatial scale at which analytical results are applicable, and the use of only one sampling scale for a particular statistical method may lead researchers to overlook important factors affecting gene flow. The particular analytical technique used to correlate landscape data and genetic data may also influence results; common landscape‐genetic methods may not be suitable for all study systems, particularly when the rate of landscape change is faster than can be resolved by common molecular markers.