bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pulmonary Embolism: Long‐term Follow‐up after Treatment with Full‐dose Heparin, Streptokinase or Embolectomy
Authors: LUND OLE , NIELSEN TORSTEN TOFTEGAARD , RØNNE KNUD , SCHIFTER SØREN 
Published: August 2010

ABSTRACT. Lund, O, Nielsen, TT, Rønne, K, Schifter S (Departments of Thoracic and Cardiovascular Surgery, Cardiology, Respiratory Diseases, and Clinical Physiology and Nuclear Medicine, Aarhus University Hospital, Aarhus, Denmark). Pulmonary Embolism: Long‐term follow‐up after treatment with full‐dose heparin, streptokinase or embolectomy. Acta Med Scand 1987; 221:61–71.The study comprises 74 patients alive 30 days after the start of treatment of pulmonary embolism with heparin (n=32), streptokinase (n=22) or embolectomy (n=20). The cumulative 5‐year survival was 100% in the embolectomy group, compared to 75±7% (SE) in the medically treated patients (p<0.05). Cancer caused 78% of the late deaths. At follow‐up 0.5–8.7 years after treatment the treatment groups were indistinguishable as regards right‐sided heart catheterization data, pulmonary artery rest‐obstruction, right ventricular diameter and wall thickness, ventilatory function and ECG changes. The embolectomized patients were in a more favourable NYHA classification level than the medically treated. Chronic pulmonary artery hypertension was found in 75 % of patients with ≤3 anamnestic recurrent embolic episodes before diagnosis compared to 8 % of patients with ≥2 recurrent episodes (p<0.001). Patients with irreversible cardiocirculatory shock before embolectomy all had abnormal pulmonary vascular resistance (>1.5 mmHg/1/min), depressed ventilatory function and more than 25% reduced pulmonary perfusion at follow‐up. The major prognostic factors thus were cancer, the number of recurrent episodes and the degree of cardiocirculatory affection in the acute event. Although the embolectomized patients were the most affected initially, they had a good prognosis. This led us to extend our indications for embolectomy to include all patients with central emboli, irrespective of the degree of cardiocirculatory impairment.
Survival of Extreme Hyperkalemia
Authors: HYLANDER B. 
Published: August 2010

ABSTRACT. Hylander B (Department of Internal Medicine, Karolinska Hospital, Stockholm, Sweden). Survival of extreme hyperkalemia. Acta Med Scand 1987; 221:121–3.Severe hyperkalemia has been reported to lead to typical ECG changes, often reflecting cardiac abnormalities which finally lead to death in arrythmias. The present report describes a 77‐year‐old male, who developed extreme hyperkalemia because of treatment with a potassium saving diuretic in combination with potassium supplementation and subsequent development of urinary retention. In spite of a maximal potassium value of 10.1 mmol/1 only non‐specific ECG‐changes were found. The patient survived after an uneventful dialysis. Thus, extreme hyperkalemia may occur without typical ECG changes and serum potassium values exceeding 10 mmol/1 may be survived.Hyperkalemia is a well‐known feature of acute renal failure. The most important toxic effects are cardiac arrythmias. In Harrison's Principle of Internal Medicine, severe hyperkalemia is defined as plasma potassium exceeding 8 mekv/l or if electrocardiographic abnormalities include absent P waves, widened QRS complexes or ventricular arrythmia (1). The following case report describes extreme hyperkalemia due to a combination of potassium saving diuretics, potassium supplementation and post‐renal failure but without specific effects on the ECG.
Alcohol Consumption and Sudden Coronary Death in Middle‐aged Finnish Men
Authors: SUHONEN OLLI , AROMAA ARPO , REUNANEN ANTTI , KNEKT PAUL 
Published: August 2010

ABSTRACT. Suhonen O, Aromaa A, Reunanen A, Knekt P (Research Institute for Social Security, the Social Insurance Institution, Helsinki, Finland). Alcohol consumption and sudden coronary death in middle‐aged Finnish men.The association between consumption of alcoholic beverages (spirits, beer and wine) and coronary heart disease (CHD) mortality, especially the incidence of sudden coronary death (SCD), was investigated in a 5‐year prospective population study comprising 4532 men aged 40–64 years. The amount of alcohol used was estimated on the basis of answers to a self‐filled structured questionnaire. The incidence of SCD was statistically significantly lower among abstainers than among alcohol consumers. The relative risk of SCD of alcohol consumers in comparison with abstainers was largest in the oldest age group and it became more apparent after a follow‐up of a couple of years. Only the consumption of spirits was positively associated with the incidence of SCD. Among non‐smokers the incidence of SCD was statistically significantly higher in consumers than in abstainers, a similar but not significant trend was observed among current smokers. The positive association between alcohol consumption and incidence of SCD was detected both in CHD‐free men and in men with prior CHD. Consumption of alcoholic beverages, and in particular of spirits, is associated with an increased risk of SCD in Finnish men.
Reduced High Density Lipoproteins as a Risk Factor after Acute Myocardial Infarction
Authors: FRANZÉN JOHAN , JOHANSSON BENGT W. , GUSTAFSON ANDERS 
Published: August 2010

ABSTRACT. FranzÉn J, Johansson BW, Gustafson A (Department of Internal Medicine, University Hospital, Lund and Section of Cardiology, Department of Internal Medicine, MalmÖ General Hospital, MalmÖ, Sweden). Reduced high density lipoproteins as a risk factor after acute myocardial infarction.In a group of normocholesterolemic, non‐diabetic middle‐aged males surviving an acute myocardial infarction for 4±2 years (mean ± SD), we have previously described a low apolipoprotein A‐1 and a deficient fibrinolytic activity as two major characteristics. In the present study we have followed morbidity and mortality risk factors for five years in these males. Mortality was 40% in a hypertensive group and 16% in a normotensive group. In the normotensive group mortality was related to reinfarction. Furthermore, patients with a poor prognosis in the normotensive group had lower high density lipoprotein (HDL) cholesterol and lower apolipoprotein A‐I concentration in plasma than patients with a good prognosis. Unexpectedly, in the hypertensive group death was related to a low (p<0.05) cortisol concentration in urine. It is concluded that a low HDL level may be a bad prognostic sign in males who have sustained an acute myocardial infarction and show no evidence of other risk factors, such as diabetes, hypercholesterolemia or hypertension.
Brain damage in alcoholism: Current concepts
Authors: Lishman William A , Jacobson Robin R , Acker Clare 
Published: August 2010

AbstractCurrent views concerning the brain damage occasioned by alcohol abuse are reviewed. Diffuse cerebral changes appear to be common and partially reversible with prolonged abstinence. The possible determinants of such changes, and their relevance to functional deficits are discussed, with illustrations from work currently proceeding at the Institute of Psychiatry. Possible interactions between cortical and subcortical pathologies in contributing to the cognitive deficits shown by alcoholic patients are emphasised.
The roles of alcohol in the epidemiology of cardiovascular diseases
Authors: Criqui Michael H 
Published: August 2010

AbstractAlcohol, both alone and in concert with deficiencies or excesses of other substances, can produce cardiomyopathy. In addition, alcohol can directly affect the cardiac‐conduction system and produce arrhythmias. A Icohol also affects kno wn risk factors for stroke and coronary heart disease (CHD). Alcohol increases blood pressure, which may lead to hypertension and thus increase the risk of stroke. HDL cholesterol, which is inversely related to CHD risk, increases with alcohol, and LDL cholesterol, which is positively related to CHD risk, may decrease with alcohol, a potentially dually protective effect. However, both case‐control and population based studies indicate only moderate levels of consumption, defined as two drinks per day or less, may be of benefit.Preliminary data from the Lipid Research Clinics Follow‐up Study suggest that the beneficial effect of moderate amounts of alcohol may be mediated in part by increased HDL cholesterol and in part by another factor, possibly reduced coagulation. Clinical and laboratory data, in addition to epidemiologic data, suggest alcohol intake above two drinks per day leads to excess cardiovascular disease (CVD), probably reflecting hypercoagulability as well as hypertension at higher levels of intake.Because alcohol can lead to excess morbidity and mortality from CVD as well as several other diseases and conditions, public health policy should continue to discourage the drinking of alcohol, especially non‐moderate consumption.
Alcoholic registration and cardiovascular morbidity and mortality ‐ a prospective study in middle aged Swedish men
Authors: Rosengren Annika , Wilhelmsen Lars 
Published: August 2010

AbstractThe consequences of alcoholic intemperance and economic problems on CHD mortality and morbidity were studied among the participants in a large primary preventive trial. Official register data were used. Subjects registered with the Board of Social Welfare were categorised with respect to increasing load of alcoholic intemperance. Non‐fatal CHD was not related to alcoholic problems. Fatal CHD, on the other hand, was strongly associated with registration for intemperance. This was especially pronounced for cases dying suddenly from CHD. A multivariate analysis was performed, controlling for smoking, systolic blood pressure and scrum cholesterol, which showed that the association between intemperance and fatal CHD was independent of these factors.
What supports the role of alcohol as a risk factor for stroke?
Authors: Hillbom Matti E 
Published: August 2010

AbstractFor more than 30 years, clinical observations to link alcohol abuse and stroke have accumulated in several countries. Studies of general populations have indicated that the risk for stroke increases with increasing alcohol consumption. Studies of young victims of stroke where the classical risk factors of stroke are uncommon, have demonstrated that even occasional heavy drinking carries an increased risk for stroke. In particular, the increased occurrence of strokes during weekends, the very time of heavy alcohol consumption in non‐alcoholics, supports this notion. Alcoholics seem to get their strokes at an earlier age than non‐alcoholics. Paradoxically, the published evidence has implicated drinking in both ischemic and hemorrhagic strokes, which suggests that there may be more than one mechanism by which alcohol can increase the risk. Strokes seem to be precipitated during the alcohol intoxication itself rather than the following withdra wal syndrome, but the contributing mechanisms, except for bleedings caused by external violence, are unknown. Alcohol can produce fluctuations in platelet reactivity and untoward interactions with certain drugs, but it remains to be demonstrated that such effects are temporally related to the onset of ischemic and hemorrhagic strokes.
The consequences of reviewing serial changes in the Minnesota code for diagnosis of acute myocardial infarction
Authors: WOLF H.K. , RAUTAHARJU P.M. , MACKENZIE B.R. , GREGOR R.D. , MILSOM D.S. 
Published: August 2010

ABSTRACT. We investigated the effect of reviewing serial electrocardiograms (ECGs) for significance of changes in the Minnesota code, and the influence of this effect on the MONICA diagnosis of myocardial infarction (MI). We used the data from 1340 consecutive admissions to the coronary care units of our MONICA centre and we developed ECG classifications and MONICA diagnoses that were based once on the unreviewed Minnesota code and once on the reviewed code.A comparison of the two ECG classifications showed that codes for evolution of Q‐waves and injury currents were much more likely to change as a result of a review (46.8 %) than codes for evolution of repolarization changes (12.8 %).The review of serial Minnesota codes caused a change of the MONICA diagnosis primarily in the category definite Ml (10 %). In a blinded clinical assessment, the cases that changed diagnosis were judged to be different from those that remained constant. It is concluded that the use of ECG classification based on unreviewed Minnesota code changes introduces heterogeneity. The significance of this effect depends on the use of the results.
Comparison of event rates among three MONICA centres
Authors: BEAGLEHOLE R. , DOBSON A. , HOBBS M. , JACKSON R. , JAMROZIK K. , ALEXANDER H. , STEWART A. 
Published: August 2010

ABSTRACT. Data from three MONICA centres in Auckland (New Zealand) and Newcastle and Perth (Australia) are used to explore some of the issues involved in comparing event rates and case fatality among MONICA centres. Auckland and Newcastle follow the »hot pursuit» method of identifying and interviewing patients while they are still in hospital. Perth follows the »cold pursuit» method, in which patients are identified by search of computerized hospital records after discharge and all data are abstracted retrospectively from case notes. Fatal cases are identified by the same method in the three centres.The distribution of events by MONICA diagnostic classification varied among centres, with Perth having the highest proportion of definite myocardial infarction events and the lowest proportion of possible myocardial infarction events. These differences appear to be due to the different methods of event ascertainment and data collection, and to variations in post mortem rates between centres. For comparisons among these three centres, the categories of non‐fatal definite myocardial infarction and of all coronary heart disease deaths (that is those in the MONICA categories fatal definite myocardial infarction, fatal possible myocardial infarction, and fatal cases with insufficient data) appear to be the most useful.
Once Daily Dosing of Enalapril in Congestive Heart Failure
Authors: AHLNER JOHAN , BERGDAHL BJÖRN , DAHLSTRÖM ULF , OHLSSON JAN 
Published: August 2010

ABSTRACT.Enalapril 40 mg or tolerated dose was given once daily to 21 patients with congestive heart failure (CHF), NYHA class III, in addition to treatment with digoxin and/or diuretics. After an 8‐week open period, 19 patients were randomized to continue enalapril or to receive a placebo in a double‐blind manner. After the first enalapril dose of 10 mg, maximal reduction of blood pressure (BP) occurred after 4 hours (mean 34/17 mmHg;p<0.001). No further reduction was found after higher doses. After the open period significant improvement was shown as judged by NYHA class (p<0.01), stroke volume (p<0.05), maximal working capacity (p<0.05), heart volume (p<0.01) and maximum rate pressure product (RPPmax) (p<0.001). Urinary aldosterone markedly decreased (p<0.01), whereas serum potassium and serum creatinine slightly increased (p<0.05). At the end of the blind period enalapril was superior to placebo concerning NYHA class (p<0.01), heart volume (p<0.05) and RPPmax (p<0.05). Other parameters, including aldosterone in urine, did not differ between the groups. Carry‐over effects may have diminished the differences between enalapril and placebo. Diarrhoea (n=5) and hypotension (n=5) were the most common side‐effects. Overall, enalapril was well tolerated and seems to be useful in single daily doses in the treatment of CHF.
The Effect of Enalapril and Timolol on Blood Lipids: A Randomized Multicenter Hypertension Study in General Practice in Norway
Authors: Leren Paul , FOSS PER OLAV , NORDVIK BJØRN , FOSSBAKK BENDT 
Published: August 2010

ABSTRACT.In a 24‐week randomized, single‐blind study Timolol (n=63) and Enalapril (n=57) proved to be potent and safe antihypertensive drugs. However, the effect on lipid metabolism was fundamentally different, despite the fact that the effect on total serum cholesterol did not significantly differ between the two groups. Enalapril had no adverse effect on any lipid fractions, while Timolol increased very low (VLDL) + low (LDL) density lipoprotein cholesterol by 7.6% (p<0.001) and total triglycerides by 34.5% (p<.001), and decreased the favorable high density lipoprotein (HDL) cholesterol by 11.3% (p<0.001). Thus, the ratio HDL/VLDL + LDL cholesterol was reduced by 17.1 % (p<0.001). Enalapril reduced uric acid by 3.4% (NS), while Timolol increased uric acid by 4.0% (p<0.05). The difference between the groups was statistically significant (p<0.01). The first steps in any attempt to solve the hypertension‐coronary dilemma should be to take into consideration all pharmacologic effects of antihypertensive drugs.
Effects of Chronic Iron Deficiency Anaemia on Myoglobin Content, Enzyme Activity, and Capillary Density in the Human Skeletal Muscle
Authors: CELSING FREDRIK , EKBLOM BJÖRN , SYLVÉN CHRISTER , EVERETT JAN , ÅSTRAND PER‐OLOF 
Published: August 2010

ABSTRACT.The influence of chronic iron deficiency anaemia on myoglobin content, maximal enzyme activities and capillarization in the human skeletal muscle was investigated. Muscle samples from musculus vastus lateralis were screened in an Indonesian population. The causes of iron deficiency were chronic intestinal bleeding or repeated pregnancy combined with low iron intake. The maximal activities of iron‐dependent and non‐iron‐dependent glycolytic and oxidative enzymes as well as myoglobin showed similar values in the iron‐deficient group and the matched control group. The activities of the oxidative enzymes in both the iron‐deficient group and the controls were lower, however, compared even to untrained Swedish subjects. The capillary density was essentially within a normal range in both groups. It is concluded that chronic iron deficiency anaemia of a moderate or severe degree, with Hb concentrations of about 80–100 g.1‐1, does not cause an impaired biochemical function of the human skeletal muscle.
Latching onto life: living in the area of tension between the possibility of life and the necessity of death
Authors: Sæteren Berit , Lindström Unni Å , Nåden Dagfinn 
Published: August 2010

Aim. To present one of the findings from a large‐scale hermeneutic research project focusing on promoting a deeper understanding of health and suffering because of serious cancer disease.Background. Although suffering is a main concern for caring science, there is limited research focusing on the suffering of the patients with a serious cancer disease from the patients’ perspective and few studies focusing on the patient’s health recourses and the dialectic between these.Design. The study has a hermeneutic design inspired by Gadamer’s ontological hermeneutics.Method. Fifteen Norwegian patients with cancer disease were interviewed. They were informed about the seriousness of their situation and that there was no more curative treatment to offer.Results. The results show that the patients lived their lives in a dialectic oscillation, a struggle between health and suffering. They expressed health through striving towards normal life, aspiring for hope, taking responsibility for their own life and experiencing belongingness with their next of kin. Suffering was expressed through experiences of bodily aversion, uncertainty and fear of the future, sorrow and needs, anxiety, despair and loneliness. The patients were lonely in this struggle, as conversations about existence and death did not occur, neither with the nurses nor with their next of kin. Death remained veiled in silence.Conclusions. In confronting one’s own death, there seems to be striving for health, striving for wholeness and for becoming a self in a life dominated by suffering. Becoming a self implies a desire to be a responsible human being and to experience integrity and dignity in life despite increasing dependency on others.Relevance to clinical practice. There seems to be a great need in clinical practice to give priority to, and increase, the consciousness and competence of nurses to see and respond to the spiritual/existential concerns of patients with a serious cancer disease.
New mutations inZFPM2/FOG2gene in tetralogy of Fallot and double outlet right ventricle
Authors: De Luca A , Sarkozy A , Ferese R , Consoli F , Lepri F , Dentici ML , Vergara P , De Zorzi A , Versacci P , Digilio MC , Marino B , Dallapiccola B 
Published: August 2010

De Luca A, Sarkozy A, Ferese R, Consoli F, Lepri F, Dentici ML, Vergara P, De Zorzi A, Versacci P, Digilio MC, Marino B, Dallapiccola B. New mutations inZFPM2/FOG2gene in tetralogy of Fallot and double outlet right ventricle.Conotruncal defects (CTDs) represent 15–20% of all congenital heart defects. Mutations in a number of genes have been associated with CTD in humans and animal models. We investigated the occurrence and the prevalence ofGATA4,NKX2.5,ZFPM2/FOG2,GDF1, andISLET1gene mutations in a large cohort of individuals with CTD, including tetralogy of Fallot with or without pulmonary atresia (TOF, 178 patients), double outlet right ventricle (DORV, 13 patients), and truncus arteriosus (11 patients). Denaturing high‐performance liquid chromatography (DHPLC) analysis followed by bidirectional sequencing disclosed no putative pathogenic mutation inGATA4,ISLET1, andGDF1genes. Two novel (Ile227Val, Met544Ile) and one previously reported (Glu30Gly) possibly pathogenic missense variants were identified in theZFPM2/FOG2gene in 3 sporadic patients of 202 (1.5%) with CTD, including 1 of 178 (0.6%) with TOF and 2 of 13 (15.4%) with DORV. Mutation analysis also detected one known missense change (Arg25Cys) inNKX2.5gene in two (1.1%) sporadic patients with TOF. These sequence alterations were found to be absent in 500 population‐matched controls. In conclusion, the present results (i) indicate and confirm that mutations in theGATA4,GDF1, andISLET1genes are not major determinants in the pathogenesis of TOF, (ii) provide supportive evidence of an association betweenZFPM2/FOG2gene and TOF/DORV, and (iii) provide additional examples of the possible contribution of the Arg25Cys change in theNKX2.5to a small number of TOF cases.
Disruption of the SCN2A and SCN3A genes in a patient with mental retardation, neurobehavioral and psychiatric abnormalities, and a history of infantile seizures
Authors: Bartnik M , Chun‐Hui Tsai A , Xia Z , Cheung SW , Stankiewicz P 
Published: August 2010

Bartnik M, Chun‐Hui Tsai A, Xia Z, Cheung SW, Stankiewicz P. Disruption of the SCN2A and SCN3A genes in a patient with mental retardation, neurobehavioral and psychiatric abnormalities, and a history of infantile seizures.Mutations in genes encoding voltage‐gated sodium channels are significant factors in the etiology of neurological diseases and psychiatric disorders, including various types of idiopathic epilepsy. Using a clinical exon‐targeted oligonucleotide array comparative genomic hybridization (aCGH), we have identified a de novo∼110‐kb deletion involving exons 1–2 of SCN2A and non‐coding exon 1a of SCN3A in a 25‐year‐old female with mental retardation, neurobehavioral and psychiatric abnormalities, and a history of infantile seizures with abnormal EEG. We propose that haploinsufficiency of SCN2A may play an important role in the genetic basis of neurodevelopmental and neurobehavioral disorders and emphasize the efficacy of detecting exonic copy‐number variation (CNV) by exon‐targeted oligo aCGH.