bluuebunny/crossref_metadata_2025_split huggingface dataset:
Design and feasibility
Authors: BERGLUND G. , ELMSTÅHL S. , JANZON L. , LARSSON S. A. 
Published: August 2009

Abstract. The Malmö Diet and Cancer study is a 10‐year prospective case‐control study in 45–64‐year‐old men and women (n = 53.000) living in a city with 230000 inhabitants. One objective is to clarify whether a western diet is associated with certain forms of cancer whilst taking other life‐style factors into account. Another broad question is whether oxidative stress and the activity in DNA‐repairing systems influence the impact of diet on the development of all or certain forms of cancer. The study is also to act as a resource available for testing new hypotheses emanating from other studies.Initially food intake, heredity, socio‐economic factors, life‐style pattern, occupational situation, previous and current diseases, symptoms and medications, will be determined. Viable lymphocytes, granulocytes, erythrocytes, and plasma/serum will be stored in a biological bank together with tumour specimens gathered from cases. The incidence and mortality of all cancer forms will then be followed for 10 years by existing registries. Data from the initial examination in these cases will then be compared with those of control subjects not having developed any form of cancer. A biomarker programme, utilizing the biological bank, has been developed and is aimed at finding predictors and/or precursors of cancer. A high participation rate (> 70%) and a high quality biological bank are prerequisites for a successful project. The experience gathered so far indicates that these goals are feasible.
Day and night variation in ambulatory blood pressure in type 1 diabetes mellitus with nephropathy and autonomic neuropathy
Authors: TORFFVIT O. , AGARDH C.‐D. 
Published: August 2009

Abstract. The objective was to study ambulatory blood pressure and heart rate variability between day and night in patients with type 1 (insulin‐dependent) diabetes mellitus with different degrees of diabetic nephropathy, and to evaluate the influence of autonomic neuropathy and type of antihypertensive treatment.Twenty type 1 diabetic patients with diabetic nephropathy and antihypertensive treatment were studied with 24‐h ambulatory blood pressure monitoring using an oscillometric method. They were compared with eight insulin‐treated diabetic patients with short duration of diabetes (1–5 years) and with 10 apparently healthy subjects. The degree of autonomic neuropathy was evaluated by measuring the RR‐interval during deep breathing and uprising.The 24‐h blood pressure was generally higher in patients with diabetic nephropathy compared to those other two groups. These patients also had a lower ratio between day and night in diastolic blood pressure compared to the control subjects (1.15 ± 0.12 vs. 1.25 ± 0.76, P < 0.05) and heart rate compared to the diabetic patients without nephropathy, as well as the control subjects (1.15 ± 0.08 vs. 1.26 ± 0.09 vs. 1.27 ± 0.08, P < 0.01, respectively). All patients with diabetic nephropathy had clinical signs of autonomic neuropathy as judged by RR‐interval measurements during deep breathing and uprising.
Determination of urinary N‐acetyl‐beta‐glucosaminidase in patients with hypertension and renal artery stenosis
Authors: STERNER G. , WEIBULL H. , HULTBERG B. , BERGQVIST D. , HULTHÉN L. , ISAKSSON A. , MANHEM P. 
Published: August 2009

Abstract. The purpose of the study was to measure the urinary excretion of N‐acetyl‐beta‐glucosaminidase (U‐NAG) in patients suspected of having renovascular hypertension and to compare the enzyme excretion before and after active intervention with operation or percutaneous transluminal renal angioplasty (PTRA).Eighty‐one patients with severe, therapy‐resistant hypertension were examined with regard to renal artery stenosis (RAS). At least one significant renal artery stenosis was found in 61 patients, whilst the remaining 20 patients were classified as having essential hypertension.Enzyme levels were found to be significantly higher in RAS patients as compared with patients with severe hypertension lacking significant renal artery stenosis, 0.66 (0.41–0.91, median value, 1st and 3rd quartiles) versus 0.35 (0.27–0.54); P < 0.01. Both groups of patients had significantly higher U‐NAG values than a healthy reference population (0.2, 0.13–0.27; P < 0.01). Forty of the RAS patients were randomized to surgery or PTRA and followed prospectively for 2 years. After either renal vascular surgery or PTRA a significant rise in U‐NAG excretion was observed 7–10 days after treatment. Urinary NAG excretion remained elevated during long‐term follow‐up. It is suggested that U‐NAG should be determined in patients with therapy‐resistant hypertension with suspicion of renal artery stenosis.
Sonography of the achilles tendon in hypercholesterolaemia
Authors: KOIVUNEN‐NIEMELÄ T. , ALANEN A. , VIIKARI J. 
Published: August 2009

Abstract. Objectives. Tendon xanthomas cause thickening of the tendon and are an important sign in monogenic familial hypercholesterolaemia (FH). The aim of our study was to investigate the usefulness of achilles tendon sonography in detecting FH patients. Special attention was paid to structural abnormalities of the achilles tendon.Design. A clinical study with methodological testing.Setting. Patients suspected of having FH were sent to the out‐patient Department of Medicine from other departments of Turku University Central Hospital and from primary care units. The patients were studied by high‐frequency ultrasound before more exact typing of the lipid disorder. An additional study of normolipidaemic volunteers and a phantom study were also carried out.Subjects. Forty FH patients, 51 non‐FH hypercholesterolaemia patients and 41 normolipidaemic volunteers were included in the study.Main outcome of measures. The thickness of the tendon was measured and the tendon structure and its echogenicity were recorded.Results. Twenty‐five out of 40 (63%) FH patients had distinctly thickened tendons (men more than 10 mm, women more than 9 mm). Thirty‐six (90%) had a typical structural alteration of low or mixed echogenicity of the tendon. Three non‐FH patients were found to have xanthomas on sonography.Conclusions. We conclude that ultrasonography is a sensitive method of detecting xanothomas that reveals the altered tendon structure even in xanthomatous tendons of normal thickness.
Behaviour therapy versus doctor's anti‐smoking advice in diabetic patients
Authors: SAWICKI P. T. , DIDJURGEIT U. , MÜHLHAUSER I. , BERGER M. 
Published: August 2009

Abstract. Objectives. To evaluate the efficacy of a structured behaviour therapy programme on smoking cessation in diabetic patients.Design. Prospective, randomized, controlled intervention study.Setting. University out‐patient diabetes clinic.Subjects. A total of 794 consecutive insulin‐treated smoking diabetic patients were invited to participate in a smoking cessation programme. Eighty‐nine patients agreed to participate and were randomized in two groups.Interventions. Forty‐four patients were randomized to a structured extensive behaviour therapy anti‐smoking intervention and 45 patients to a control group that received a single unstructured anti‐smoking advice session given by a physician.Main outcome measures. After 6 months, nine patients were confirmed not to be smoking (i.e. urine cotinine concentration below 20 ng ml−1, 2 [5%] in the behaviour therapy intervention group and 7 [16%] in the control group.Conclusions. In diabetic patients an extensive behaviour therapy intervention for smoking cessation is no more successful than an unstructured physician's advice.
Effects of transdermal 17β‐oestradiol combined with oral progestogen on lipids and lipoproteins in hypercholesterolaemic postmenopausal women
Authors: SLOWIÑSKA‐SRZEDNICKA J. , ZGLICZYÑSKI S. , CHOTKOWSKA E. , SRZEDNICKI M. , STOPIÑSKA‐GLUSZAK U. , JESKE W. , BRZEZIÑSKA A. , ZGLICZYÑSKI W. , ADOWSKI Z. S. 
Published: August 2009

Abstract. Objectives. The purpose of the study was to evaluate the effect of transdermal 17β‐oestradiol with oral progestogen on the plasma levels of lipids, lipoproteins and apolipoproteins in hypercholesterolaemic postmenopausal women.Design. During 6 months of replacement therapy with transdermal 17β‐oestradiol combined with oral progestogen, plasma lipids, lipoproteins and apolipoproteins after 3 and 6 months were measured and compared with pretreatment values by Student's t‐test.Setting. From January 1992 until September 1992 patients were diagnosed and treated in an outpatient clinic of the Department of Endocrinology Medical Centre for Postgraduate Education, Warsaw.Subjects. The patients studied were 11 non‐obese postmenopausal women with hypercholesterolaemia based on the World Health Organization criteria.Interventions. Venous blood samples were obtained before and 3 and 6 months after the beginning of cyclic replacement therapy with transdermal 17β‐oestradiol (E2 100 μg day−1 combined with oral chlormadinone acetate (2 mg day−1 for 7 days in each cycle).Main outcome measures. The antiatherogenic effect of transdermal oestrogen replacement therapy exerted by increased levels of high‐density lipoprotein sub‐fraction 2 cholesterol (HDL2‐C) leading to the decrease of the total cholesterol level was anticipated.Results. After 6 months of the treatment the concentrations of HDL2 cholesterol (HDL2‐C) increased from 0.45 ± 0.07 mmol l−1 to 0.73 ± 0.03 mol l−1 (P < 0.05) but the levels of HDL3 cholesterol (HDL3‐C) decreased from 1.15 ± 0.06 mmol l−1 to 0.89 ± 0.07 mmol l−1 (P < 0.05). The concentrations of total cholesterol decreased from 6.9 ± 0.13 mmol l−1 to 6.2 ± 0.2 mmol l−1 (P < 0.05). No changes were observed in the plasma levels of total triglycerides, HDL cholesterol, low‐density lipoprotein (LDL) cholesterol, very‐low‐density lipoprotein (VLDL) cholesterol, VLDL triglycerides, apolipoproteins A‐I and B.Conclusions. In hypercholesterolaemic postmenopausal women, transdermally administered 17β‐oestradiol 100 μg daily in combination with oral chlormadinone acetate has a beneficial effect through raising the level of the antiatherogenic HDL2‐C subfraction and decreasing the level of total cholesterol.
Altered adrenocorticotropin and Cortisol secretion in abdominal obesity: implications for the insulin resistance syndrome
Authors: HAUTANEN A. , ADLERCREUTZ H. 
Published: August 2009

Abstract. Objectives. To investigate the relationship between the pituitary‐adrenocortical function, abdominal obesity, and insulin resistance syndrome.Design. A prospective study.Setting. Helsinki University Hospital, Finland.Subjects. Sixty‐six healthy males aged 30–55 years.Main outcome measures. Insulin, C‐peptide, Cortisol and ACTH responses during the oral glucose tolerance test (OGTT), and the Cortisol response to dexamethasone suppression and intravenous adreno‐corticotrophic hormone (ACTH) stimulation.Results. The subjects in the highest tertile of the waist‐to‐hip ratio (WHR) had lower high‐density lipoprotein cholesterol (HDLC) (P < 0.05), but higher triglyceride (TG), insulin, and C‐peptide levels, ACTH response to glucose at 2 h, and Cortisol response to ACTH (P < 0.01) than those in the lowest tertile. The Cortisol response to ACTH correlated positively, but Cortisol levels during the OGTT correlated negatively with WHR. The ratio of these Cortisol determinations correlated positively with the body‐mass index (BMI) (r = 0.554; P < 0.001), WHR (r = 0.536; P < 0.001), TG (r = 0.397; P = 0.001), fasting insulin (r = 0.534; P < 0.001) and C‐peptide (r = 0.458; P < 0.001), and negatively with HDLC (r = 0.353; P = 0.004). In multiple regression analyses, BMI and the 2‐h ACTH response to glucose were significant predictors of WHR and, in addition, the Cortisol ratio, WHR, and BMI of insulin.Conclusions. Abdominal obesity may be associated with subtle central adrenal insufficiency, which might also affect insulin and lipoprotein metabolism.
Complete membranous obstruction of the inferior vena cava: clinical characteristics of Chinese patients
Authors: CHAN P. , LEE C. P. , YANG C. Y. , HUNG J. S. 
Published: August 2009

Abstract. Objectives. To analyse the clinical presentations of membranous‐type Budd‐Chiari syndrome and the long‐term outcome of balloon angioplasty.Design. A case‐control study. Patients who received abdominal sonography and were suspected of having hepatic venous outflow obstruction were advised to receive cardiac catheterization and angiography.Setting. Patients were collected from Chung Hisao Hospital and Chang Gung Medical Centre. Angioplasty was done at Chang Gung Medical Centre.Subjects. Seventeen patients who had the symptoms and signs of portal hypertension were suspected of having hepatic venous outflow obstruction after abdominal sonography and a radionuclide liver scan and eight of them were confirmed as having membranous‐type obstruction.Interventions. Simultaneous catherization and contrast angiography was performed via the right brachial and femoral veins. Angioplasty was performed afterwards.Main outcome measures. The remission of clinical symptoms and signs and a decrease of the pressure gradient between the right atrium and inferior vena cava were used as indicators of successful intervention.Results. All patients had remarkable remission of symptoms and signs. The average pressure gradient between right atrium and inferior vena cava dropped from 16.5 ± 1.6 to 6.5 ± 1 mmHg (mean ± su).Conclusion. The clinical presentations of membranous‐type Budd‐Chiari syndrome are somewhat different from hepatic vein occlusion. Balloon angioplasty may be a modality for curing this disease. A larger patient population is necessary to confirm this study.
Distinguishing acyclovir neurotoxicity from encephalomyelitis
Authors: RASHIQ S. , BRIEWA L. , MOONEY M. , GIANCARLO T. , KHATIB R. , WILSON F. M. 
Published: August 2009

Abstract. Objectives. To define the clinical characteristics of acyclovir neurotoxicity and to outline how to distinguish it from viral encephalitis.Design. Case series of acyclovir neurotoxicity.Setting. All cases reported in Index Medicus or in bibliographic reviews of acyclovir neurotoxicity plus two representative studies of Varicella zoster and Herpes simplex virus encephalitis.Subjects. Thirty‐five patients who developed neuropsychiatry symptoms during acyclovir therapy.Interventions. Analysis of the patients' demographics, risk factors, acyclovir dosages and duration, clinical and laboratory findings and outcome.Main outcome measures. All clinical and laboratory findings that were statistically significantly different from viral encephalitis.Results. The median age was 53.3 years. The most common predisposing factors were the use of other potentially neurotoxic medications (17 cases) and acute or chronic renal failure (15 cases). Acyclovir levels were frequently found above the therapeutic range. The characteristic manifestations were confusion (15 cases), hallucination or delirium (9 cases), agitation (8 cases) and lethargy (10 cases). Few patients had associated tremors (11 cases). Fever, headache, seizures and focal neurologic findings were distinctly rare. Cerebrospinal fluid and computed tomography were normal except in patients with other central nervous system disorders. Symptoms appeared within 2 days of therapy in the majority and resolved completely within several days of discontinuing acyclovir.Conclusions. Acyclovir neurotoxicity is a self‐limiting, dose‐dependent phenomenon which is more common in the elderly, in patients with renal failure or in association with other neurotoxic medications. It is distinguished from viral encephalitis by its sudden onset, absence of fever or headache, lack of focal neurologic findings and normal cerebrospinal fluid.
The Helsinki Heart Study: coronary heart disease incidence during an extended follow‐up
Authors: Heinonen O. P. , Huttunen J. K. , Manninen V. , Mänttäri M. , Koskinen P. , Tenkanen L. , Frick M. H. 
Published: August 2009

Abstract. Objectives. To confirm that coronary heart disease (CHD) can be prevented by gemfibrozil treatment and to estimate the long‐term effect of the treatment.Design. All participants of the Helsinki Heart Study, a controlled 5‐year CHD primary prevention trial with gemfibrozil and placebo, were offered gemfibrozil treatment and biannual follow‐up for 3.5 more years.Setting. By the end of the multi‐clinic double‐blind trial, a 34% difference in definite cardiac events (56 vs. 84; P < 0.2) had developed between the gemfibrozil and placebo groups.Subjects. There were 2046 dyslipidaemic men in the gemfibrozil group at randomization, 1961 started the extended follow‐up; the comparison group comprised 2035 men, and 5 years later 1928 men.Interventions. Gemfibrozil was selected by 66.3% of gemfibrozil and 68.5% of placebo men without previous CHD end‐points.Main outcome measures. Definite fatal and non‐fatal CHD events are reported, possible CHD events were recorded but reported selectively.Results. During the post‐trial period the numbers of definite CHD events in both groups (54 vs. 47; NS) were smaller than expected without treatment, namely a reduction of around 40% for the original treatment groups. The mean incidence rates were in fact similar to that in the placebo group 5 years earlier. The post‐trial CHD incidence was lowest amongst the placebo group men who later selected gemfibrozil. Cardiovascular mortality over the entire study period was similar but all‐cause mortality was slightly higher amongst men of the original gemfibrozil group compared to the placebo group men (P = 0.19).Conclusions. Thus prolonged gemfibrozil treatment postpones cardiac events. This protective effect presumably involves both attenuation of atherosclerosis and mechanisms related to acute cardiac events.
Tissue plasminogen activator for hepatic vein thrombosis in paroxysmal nocturnal haemoglobinuria
Authors: McMullin M. F. , Hillmen P. , Jackson J. , Ganly P. , Luzzatto L. 
Published: August 2009

Abstract. Paroxysmal nocturnal haemoglobinuria (PNH) is an acquired clonal disorder thought to arise in a multipotent haemopoietic stem cell. A distinct clinical feature is a tendency to thrombosis, with a particular predilection for the hepatic veins (Budd‐Chiari syndrome).We report here on two patients with PNH who developed hepatic vein thrombosis (HVT) and who were treated with tissue plasminogen activator (t‐PA). Both patients had a marked clinical and radiological improvement following the t‐PA treatment and remain well over 2 years and 6 years after the treatment. This method of thrombolysis for HVT occurring in PNH has only been reported in two previous patients with limited follow‐up. We suggest that this therapy is a useful first‐line treatment for PNH patients who develop HVT.
Haematocrit, hypertension and risk of stroke
Authors: Wannamethee G. , Perry I. J. , Shaper A. G. 
Published: August 2009

Abstract. Objectives. To assess the relationship between haematocrit and risk of stroke.Design. Prospective study of a cohort of men followed up for 9.5 years.Setting. General practices in 24 towns in England, Scotland and Wales (British Regional Heart Study).Subjects. A total of 7735 men aged 40–59 years at screening, selected at random from one general practice in each of 24 towns.Main outcome measures. Fatal and non‐fatal strokes.Results. During a follow‐up period of 9.5 years for all men there were 123 stroke events (33 fatal) in the 7346 men in whom the haematocrit level had been determined. In the cohort as a whole, risk of stroke was significantly raised at haematocrit levels ≥ 51% (relative risk [RR] = 2.5; 95% confidence intervals [CI] 1.2–5.0) after adjustment for age, social class, smoking, body mass index, physical activity, presence of diabetes and pre‐existing ischaemic heart disease. Further adjustment for systolic blood pressure did not attenuate this association (RR = 2.4; 95% CI 1.2–4.9). A raised haematocrit was associated with an increase of stroke only in men with hypertension (systolic blood pressure ≥ 160 mmHg or diastolic blood pressure ≥ 90 mmHg or on regular antihypertensive treatment). No increased risk of stroke was seen at the higher haematocrit level (≥ 51%) in normotensive men. At haematocrit levels below 51%, hypertension was associated with a three‐fold increase in risk of stroke compared with normotension (RR = 3.4, 95% CI 2.3, 5.1). At haematocrit levels 51%, hypertension was associated with a nine‐fold increase in risk of stroke compared with normotension (RR = 9.3; 95% CI 4.2, 21.0). Exclusion of men receiving regular antihypertensive therapy did not alter the strong associations seen.Conclusion. The data suggest that an elevated haematocrit is an independent risk factor for stroke and that it interacts synergistically with elevated blood pressure.
Sarcoidosis and agnogenic myeloid metaplasia
Authors: Reich J. M. 
Published: August 2009

Abstract. Agnogenic myeloid metaplasia (AMM) was recognized 3 years after a diagnosis of sarcoidosis in a 45‐year‐old man. This is the second reported instance of that association, and the 15th reported case in which systemic granulomata have been associated with a myeloproliferative disorder (MPD). In the client population at risk, this connection would be expected to occur by chance once in 1700 years. Therefore, it is unlikely that the association is fortuitous.Systemic granulomata may represent an immunologic response to antigens of neoplastic origin in MPD
Osteonecrosis of the femoral head in refractory coeliac disease
Authors: Di Sario A. , Corazza G. R. , Cecchetti L. , Tarozzi C. , Gasbarrini G. 
Published: August 2009

Abstract. Osteonecrosis has been described occurring in many clinical conditions that require steroid administration. Mechanisms by which steroids produce osteonecrosis are not well known and the importance of the underlying disease has been recently emphasized.We report on a 48‐year‐old woman with coeliac disease who developed osteonecrosis of the femoral head after being treated with steroids for non‐response to gluten withdrawal. We stress the possible role of osteoporosis and osteomalacia, frequently found in patients with coeliac disease, in the pathogenesis of this complication, and advise using drugs other than steroids in the treatment of refractory coeliac disease.
Creatine kinase‐MB mass concentration versus creatine kinase‐B activity for the detection of acute myocardial infarction in patients with slightly elevated total creatine kinase activity in serum
Authors: Hulting J. , Waldenlind L. , Onica D. , Wallinder H. 
Published: August 2009

Abstract. Objective. The diagnostic value of creatine kinase‐MB mass concentration (CK‐MB mass) was compared with that of creatine kinase‐B (CK‐B) activity in patients with suspected acute myocardial infarction (AMI) but with total serum CK activity only slightly above the reference range.Design. One hundred consecutive blood samples with total CK activity between 120 and 360 U I‐1 and CK‐B activity ≥ 9 U I‐1 were analysed. Electrophoresis of CK isoenzymes was also performed.Setting. Patients from all departments of the hospital were included. About half of the patients originated from the coronary care unit.Subjects. The blood samples derived from 49 patients. Thirteen patients had at least one serum sample with total CK activity above 360 U I‐1. These and another three patients were omitted from the study.Results. Acute myocardial infarction had been diagnosed clinically (with CK and CK‐B methods) in 12 of 33 patients. However, using the CK‐MB mass concentration of the reference method, five of these 12 patients did not have myocardial infarction whereas nine patients with small infarctions were undetected. A good correlation was seen between the results from CK‐MB mass concentration and CK isoenzyme electrophoresis, but there was a poor correlation between these methods and CK‐B activity including the CK‐B/CK ratio. A relatively high proportion (24%) of the selected patients had increased levels of macro CK.Conclusion. CK‐B activity was inaccurate for the detection of probable myocardial infarction in patients with slightly elevated total CK activity. Increased levels of macro CK interfering with the CK‐B assay was one explanation for this observation.