bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urinary thromboxane A2 metabolites in patients presenting in the emergency room with acute chest pain
Authors: Foegh M. L. , Zhao Y. , Madren L. , Rolnick M. , Stair T. O. , Huang K. S. , Ramwell P. W. 
Published: August 2009

Abstract. Objectives. The diagnosis of acute myocardial infarction (MI) is difficult in emergency rooms where large groups of patients present with chest pain. Confirmation of the diagnosis of MI based on the myocardial band of creatine phosphokinase may take a day. A more rapid diagnostic screening procedure is desirable and for this reason we evaluated urine thromboxane.Design. The study consisted of patients presenting with chest pain. Urine samples were obtained in the emergency room and on the following 5 days for those patients who were admitted to the hospital. The urine samples were used to determine the levels of immunoreactive 11‐dehydro‐thromboxane B2 (i‐11‐dehydro‐TXB2) and 2,3‐dinor‐thromboxane B2 (i‐2,3‐dinor‐TXB2). Myocardial infarction was defined as an increase in the myocardial band fraction of plasma creatine phosphokinase (> 5% of the total) and changes in the electrocardiogram. The patients' diagnoses were retrospectively correlated with thromboxane metabolite levels.Setting. The present study took place in the emergency rooms of two major hospitals: Georgetown University Medical Center. Washington DC, and Fairfax Hospital, Virginia, USA.Subjects. The study comprised 369 patients presenting with acute chest pain and consisted of 247 men and 122 women aged 30–94 years.Main outcome measures. The outcome measure of this study was the predictive value of i‐11‐dehydro TXB2 and i‐2,3‐dinor‐TXB2, for the diagnosis of MI, in patients presenting in the emergency room with chest pain.Results. Patients undergoing an MI had significantly higher levels of both thromboxane metabolites in their urine in the emergency room, when compared to patients undergoing a cardiac event other than an MI or to patients with unstable angina. Thromboxane metabolite levels rapidly returned to normal on the days following admission to the hospital. Aspirin intake appeared to significantly decrease the levels of i‐11‐dehydro‐TXB2, but not that of i‐2,3‐dinor‐TXB2.Conclusions. The measurement of thromboxane metabolites in the urine may provide a more rapid, accurate and cost‐effective means of diagnosing MIs in patients presenting with chest pain.
Functional deterioration and selenium‐vitamin E treatment in myotonic dystrophy. A placebo‐controlled study
Authors: Örndahl G. , Grimby G. , Grimby A. , Johansson G. , Wilhelmsen L. 
Published: August 2009

Abstract. Objectives. The aim of the investigations was to study the effect of a combined selenium and vitamin E treatment in patients with myotonic dystrophy.Design. A double‐blind placebo‐controlled trial.Subjects. Twenty‐seven patients with myotonic dystrophy divided into an experimental (n = 13) and a control (n = 14) group.Interventions. The experimental group was given increasing doses for 4 months up to a maximum of 1.6 mg selenium and 800 mg vitamin E daily and the control group a corresponding number of placebo tablets. The total treatment period was 2 years.Main outcome measures. Muscle strength (knee extension, knee flexion, hand‐grip), maximal walking speed for 30 m, function in daily activities (disability), well‐being and cognitive functioning.Results. Before treatment, muscle strength showed moderately or markedly reduced values as did maximal walking speed. Disability was most markedly demonstrated in instrumental ADL‐activities. Spatial ability was reduced in the majority of patients. During the 2‐year follow‐up period, the hand‐grip strength and maximal walking speed decreased in both groups (P < 0.01). The reduction was not significantly different according to an ‘intention‐to‐treat‐analysis’. However, there was a significantly larger decline (P < 0.01) in the left‐hand grip strength in the control group when all the patients with complete treatment compliance were included.Conclusions. A useful set of measurements has been developed for following functional deterioration in myotonic dystrophy. No conclusive evidence of beneficial effects of selenium and vitamin E treatment has been produced.
Metabolic remission with octreotide in patients with insulinoma
Authors: Von Eyben F. E. , Grodum E. , Gjessing H. J. , Hagen C. , Nielsen H. Bech 
Published: August 2009

Abstract. Objectives. The efficacy of octreotide was studied in a group of patients with biochemical evidence of insulinoma.Design. A phase‐II studySetting. A university department of internal medicine.Subjects. Seven patients with biochemical evidence of insulinoma and without metastatic lesions.Intervention. Daily treatment with octreotide, a somatostatin analogue, mainly within the dosage of 100–300 μg day‐1. The treatment was continued in patients with biochemical evidence of response or until surgery was undertaken.Main outcome. Five patients avoided hypoglycaemic symptoms and had normalization of blood glucose values for a median of 15+ months (range 0.2–54 months). Two did not improve metabolically. The treatment was well tolerated and had no deleterious effects on blood glucose regulation.Conclusion. Octreotide seems to be a promising treatment for many of the patients with insulinoma who are not suitable for surgery.
Effects of captopril on renal function in healthy uninephrectomized subjects and in healthy control subjects
Authors: Nielsen C. B. , Pedersen E. B. 
Published: August 2009

Objectives. To study the importance of the reninangiotensin‐II system for renal haemodynamics and sodium and water handling in the adapted remnant kidney in healthy uninephrectomized subjects.Design. Case‐control study.Setting. All subjects were investigated at laboratory C, Department of Medicine and Nephrology, Skejby Hospital.Subjects. Fourteen healthy uninephrectomized (Unx) and 14 matched healthy control subjects (Cs). Intervention. Captopril, 25 mg orally.Main outcome measures. The glomerular filtration rate (GFR) and renal plasma flow (RPF) were measured by the constant infusion clearance technique using 125I‐iothalamate and 131I‐hippuran as reference substances, tubular function was evaluated by the lithium clearance technique (CLi), urinary flow rate (V), sodium excretion (UNaV), fractional sodium excretion (FENa), mean blood pressure (MBP) and heart rate (HR) were measured by conventional methods and plasma levels of angiotensin II (Ang‐II), aldosterone (Aldo), arginine vasopressin (AVP) and atrial natriuretic peptide (ANP) were measured by radioimmunoassay.Results. In both groups captopril ingestion resulted in a significant decrease in the MBP (Unx: 87.1 to 83.5 and Cs: 86.8 to 83.8 mmHg, median values), filtration fraction (Unx: 24.6 to 22.1 and Cs: 24.1 to 22.5%, median values) and Ang‐II (Unx: 10.5 to 7.7 and Cs: 12 to 7.6 pmol‐1. median values). Single kidney GFR, V, and CLi were unchanged in both groups. FENa and single kidney RPF were significantly increased in only the Cs group; FENa (Unx: 1.81 to 1.91 and Cs: 1.56 and 1.90%, median values). The plasma level of ANP was significantly decreased in only the Unx group.Conclusion. The data suggest that sodium handling in the remnant kidney in uninephrectomized subjects could be less sensitive to Ang‐II than in healthy control subjects, and that this might be as a result of adaptive changes in the distal parts of the nephron.
Fulminant hepatitis with severe lactate acidosis in HIV‐infected patients on didanosine therapy
Authors: Bissuel F. , Bruneel F. , Habersetzer F. , Chassard D. , Cotte L. , Chevallier M. , Bernuau J. , Lucet J.‐C. , Trepo C. 
Published: August 2009

We report two cases of fulminant hepatic failure in HIV‐1‐infected patients treated with didanosine (ddI). Clinical manifestations including vomiting, diarrhoea and dyspnoea were identical in both cases. Biological data mainly revealed hepatic failure and lactic acidosis. Histological examination of liver biopsies showed diffuse microvesicular steatosis. The outcome was fatal in both patients.The only comparable case previously reported (Lai et al., 1991) showed close similarities in the clinical, biological and histological manifestations with microvesicular steatosis. This prompted us to suspect that ddI might be responsible for fulminant hepatitis in all three AIDS patients. This toxic effect may be added to the list of potential adverse events occurring during ddI therapy.
Apolipoprotein (a) phenotypes and lipoprotein (a) concentrations in patients with type III hyperlipoproteinaemia
Authors: FEUSSNER G. , FEUSSNER V. , ZIEGLER R. 
Published: August 2009

Abstract. Objectives. The familial lipoprotein disorder type III hyperlipoproteinaemia (HLP) carries a marked increase in the risk of accelerated and premature atherosclerosis, but there is considerable variation amongst affected individuals in their susceptibility to cardiovascular disease (CVD). Therefore, it was the aim of our study to investigate the possible influence of lipoprotein (a) [Lp(a)] in the pathogenesis of type III HLP.Design. Apolipoprotein (a) [apo(a)] phenotypes and Lp(a) concentrations were determined in patients with the disease and in an appropriate control group.Setting. University out‐patient lipid disorder clinic.Subjects. Seventy‐six apoE‐2 homozygous patients with type III HLP and 76 normolipidaemic and healthy age‐ and sex‐matched controls.Main outcome measures. The frequencies of different apo(a) phenotypes and their correlations with Lp(a) serum concentrations were determined in patients and controls.Results. Lp(a) concentrations were not significantly different in type III HLP patients (14.1±19.1 mg dl‐1) as compared with the controls (13.3±16.2 mg dl‐1; P = 0.549, NS). In addition, there was no significant difference in apo(a) phenotype frequencies amongst both groups (0.2 > P > 0.1).Conclusions. We conclude that the apo(a) polymorphism does not participate (to a significant extent) in the phenotypical expression of type III HLP.
Carotid intima‐media thickness: correlation with the British Regional Heart Study risk score
Authors: GEROULAKOS G. , O'GORMAN D. , NICOLAIDES A. , SHERIDAN D. , ELKELES R. , SHAPER A. G. 
Published: August 2009

Abstract. Objectives. The thickness of the intima‐media (IMT) layer of the common carotid artery is a marker of severe and extensive coronary artery disease and it has been reported that it is related to the presence of risk factors for atherosclerosis. The purpose of this study was to establish whether the IMT correlates with the British Regional Heart Study (BRHS) risk score which identifies a large proportion of men who may experience a major ischaemic heart disease event within 5 years of initial screening.Subjects. High resolution ultrasonography was used to measure the thickness of the intima‐media layer in 89 individuals. The BRHS risk score of these individuals was also recorded.Main outcome measures. Correlation between the carotid IMT and the BRHS score.Results. The IMT was linearly related to the BRHS score (r = 0.56; P < 0.001). There was a highly significant difference between the mean IMT in individuals with a risk score greater and those with a risk score lesser than the 80th percentile (P < 0.001).Conclusion. It is concluded that the IMT may be a useful surrogate end‐point or biological marker of coronary artery disease and might be considered for use in prospective studies and clinical trials.
Mild haemophilia A in Iceland: clinical genetic studies of three families with the same mutation
Authors: JENSSON Ó. , BERNVIL S. STENBJERG , JÖNSÖDTTIR S. , INGERSLEV J. 
Published: August 2009

Abstract. Objectives. The aim of the study was to define the phenotype in three families with mild haemophilia A and to determine restriction fragment length polymorphisms (RFLP), which could support a hypothesis of a common progenitor of the families.Design. Family survey.Setting. Index cases were identified in and outside hospital and a family survey for symptoms and signs of bleeding in family members and sampling for coagulation and RFLP studies were mostly carried out in the field.Subject. Family members with and without symptoms of bleeding were selected for investigation and normal spouses and unrelated individuals were investigated for control.Interventions. Medical advice regarding affected family members were given to the families and their physicians.Main outcome measures. Bleeding time, factor VIII activity, quantification of factor VIII: Ag, von Wille‐brand factor (vWF) Ag and vWF ristocetin assay. Typing of RFLP polymorphisms for genetic homogeneity.Results. Bleeding manifestations are present in both sexes in the three families although more frequent and more severe in the males. The level of factor VIII activity is between 10 and 20% in most affected males whereas 35–60% is found approximately in 2/3 of female carriers and in 1/3 of them factor VIII activity is within the normal range. It is suggested that screening for this mild haemophilia A gene by a molecular genetic method would be of clinical value now, its mutation having been detected.Conclusions. Transmission of mild haemophilia A through six to seven generations is demonstrated by the study. The mild haemophilia A type described is the most prevalent of haemophilia A types in Iceland (population 260000, 1992). The founder effect was confirmed by studies of RFLP polymorphisms.
Silent pulmonary embolism in patients with deep venous thrombosis. Incidence and fate in a randomized, controlled trial of anticoagulation versus no anticoagulation
Authors: NIELSEN H. KRIEMER , HUSTED S. E. , KRUSELL L. R. , FASTING H. , CHARLES P. , HANSEN H. H. 
Published: August 2009

Abstract. Objectives. A high frequency of asymptomatic pulmonary embolism (PE) in patients with deep venous thrombosis (DVT) has been reported, but information about the outcome of the patients with PE remains sparse. The aims of the present study were to assess the prevalence of silent PE in patients with symptomatic, venographically proven DVT, and to evaluate the natural history of silent PE.Design. Consecutive patients from one centre of primary care were included in a randomized, open study with blinded control. All patients gave written, informed consent.Subjects. Eighty‐seven consecutive patients with venographically proven DVT and with a perfusionventilation lung scintigraphy performed within 48 h of the DVT diagnosis were included. On the 10th and 60th days the lung scintigraphy was repeated in 80 and 60 patients, respectively. All the patients were followed for 3 months in the out‐patient clinic.Interventions. All patients were ambulated from the first day and were allocated randomly to no anticoagulant (non‐AC) therapy or to AC therapy with intravenous heparin infusion for at least 6 days and oral AC therapy for 3 months.Results. Forty‐three of these patients had a high probability lung scintigraphy for PE. Distal vein and femoral vein thrombosis embolized in 33 and 53% of patients, respectively. The progression rate after 60 days was 3% in both the AC and the non‐AC group and after 10 days the rates were 13 and 8%, respectively.Conclusions. A high frequency of silent PE in patients with DVT both above and below the knee is demonstrated. AC treatment did not influence the resolution rate of PE or the rate of clinical PE in a 3‐month follow‐up period.
High rate of nonspecific anti‐hepatitis C reactivity amongst homosexual men in comparison with that found in other sexually active groups and blood donors
Authors: ANDREU J. , ABAD M. A. , SANCHEZ‐QUIJANO A. , TORRONTERAS R. , LUQUE F. , HERAS J. GARCIA DE LAS , SOTO B. , PINEDA J. A. , LEAL M. , LISSEN E. 
Published: August 2009

Abstract. Objectives. To investigate the concordance of antihepatitis C virus (anti‐HCV) reactivity by a second‐generation enzyme immunoassay (EIA‐2) and by a four‐antigen recombinant immunoblot assay (4‐RIBA) in homosexual men, in comparison with that found in other sexually active groups and blood donors.Design. Prospective study.Setting. Tertiary referral centre, Seville, Spain.Subjects. A total of 1203 subjects were studied. Eight hundred and three were sexually active individuals: 547 female prostitutes, 88 heterosexual men who had frequent sexual intercourse with prostitutes, and 168 homosexual men. All of them denied blood transfusion and parenteral drug use. In addition, 400 voluntary blood donors were selected at random.Main outcome measures. All serum samples were screened for anti‐HCV by EIA‐2 and repeatedly reactive sera were tested by 4‐RIBA. Homosexual men were also screened for anti‐human immunodeficiency virus (anti‐HIV), hepatitis B virus (HBV) markers and gammaglobulin concentration. Finally, serum samples from homosexual men reactive for anti‐HCV by EIA‐2 were analyzed for HCV‐RNA by polymerase chain reaction (PCR).Results. Concordance between EIA‐2 and 4‐RIBA in female prostitutes (71.4%), clients of prostitutes (75.0%), and blood donors (83.3%) was significantly higher than in homosexual men (38.8%) (P < 0.04). In this collective the concordance between 4‐RIBA and PCR was 85.7% for positive cases and 88.8% for negative ones, and EIA‐2 ratios in reactive sera were significantly higher in 4‐RIBA confirmed cases (P < 0.0001). No correlation between false positive EIA‐2 results and presence of HIV infection, HBV markers or hypergammaglobulinaemia was found in homosexual men by univariate analysis.Conclusions. There is a high level of non‐specific anti‐HCV reactivity by EIA‐2 amongst homosexual men in comparison with that found in other sexually active groups and blood donors. The true prevalence of HCV infection amongst homosexual men could be even lower than previously described.
A 5‐year prospective, observational study of the withdrawal of antihypertensive treatment in elderly people
Authors: Ekbom T. , Lindholm L. H. , Odén A. , Dahlöf B. , Hansson L. , Wester P.‐O. , Scherstén B. 
Published: August 2009

Abstract. Objectives. To observe blood pressure, cardiovascular events, and total mortality after withdrawing antihypertensive treatment for elderly patients.Design. Multicentre observational study.Setting. Sweden. A 5‐year follow‐up of 333 elderly hypertensive patients, aged 70–84 years (mean age 75.2 ± sd 3.8 years, 68% females). In all, 74 out of the 333 patients (22%) died during the study period.Method. After withdrawal of the antihypertensive therapy, all patients started in the untreated state and during the 5‐year follow‐up they could then either remain in the untreated state, or be reverted to blood‐pressure‐lowering drug treatment because of hypertension or other diseases, e.g. angina pectoris, oedema, congestive heart failure, etc.Results. The probability of remaining without treatment for 5 years was estimated to be 20%. During the state of no treatment the patients had a lower total mortality risk than that of the general Swedish population, matched for age and sex. They also had a lower risk of cardiovascular events than those in the treated states. Markers indicating a successful withdrawal were monotherapy in low doses and relatively low blood pressure before withdrawal.Conclusion. These results suggest that with frequent check‐ups, withdrawal of antihypertensive therapy in the elderly can be tried without increased risk of cardiovascular events.
A comparison of severe gastric damage as a result of pirprofen and naproxen treatment in rheumatoid arthritis: a controlled endoscopic study
Authors: MONTRONE F. , PETRILLO M. , CARUSO I. , PORRO G. BIANCHI 
Published: August 2009

Abstract. Objective. The aim of this controlled endoscopic study was to compare the therapeutic efficacy and the gastric tolerance of two nonsteroidal antiinflammatory drugs, pirprofen versus naproxen.Design. A randomized endoscopic double‐blind double‐dummy study.Setting. The gastrointestinal unit of a teaching hospital.Subjects. Forty patients suffering from rheumatoid arthritis were enrolled. After an initial upper gastrointestinal endoscopy to rule out the presence of gastric mucosal lesions, the patients were randomly allocated in a double‐blind, double‐dummy manner, to receive either pirprofen (400 mg t.i.d.) or naproxen (500 mg b.i.d.) for 4 weeks; endoscopic control followed this treatment period, or was anticipated in the event of painful dyspepsia.Interventions. Endoscopy at the beginning of the study and at 4 weeks, or anticipated in the event of painful dyspepsia.Main outcome measures. Primary outcome measure of the study was the possibility that pirprofen was less toxic to the gastric mucosa than naproxen, and at least as effective.Results. Both drugs proved effective in relieving clinical symptoms, without a statistically significant difference. Gastric mucosa lesions were observed in 90% of pirprofen‐treated patients and in 60% of those on naproxen (P = 0.03). The most severe lesions (grades 3 and 4) were found in 65% of subjects treated with pirprofen, as opposed to 15% of those treated with naproxen (P = 0.001).Conclusions. This study shows that pirprofen is at least as active as naproxen in relieving rheumatic symptoms, but its administration results in a significantly severe degree of gastric damage.
Low pulse‐wave amplitude during reactive leg hyperaemia: an independent, early marker for ischaemic heart disease and death Results from the 21‐year follow‐up of the prospective cohort study ‘Men born in 1914’, Malmö, Sweden
Authors: HEDBLAD B. , ÖGREN M. , JANZON L. , ISACSSON S.‐O. , LINDELL S. E. 
Published: August 2009

Abstract. Objective. To study the incidence of myocardial infarction, all‐cause mortality and mortality from ischaemic heart disease in relation to arterial leg blood flow determined by venous occlusion plethysmography of the calf.Design. A prospective cohort study ‘Men born in 1914’.Setting. Malmö, a city in southern Sweden with 256000 inhabitants, and a single referral hospital.Subjects. Six‐hundred and thirty‐six 55‐year‐old men, randomly selected from the general population. None of them had signs or symptoms of leg artery disease.Main outcome measures. All‐cause mortality, morbidity and mortality from ischaemic heart disease during 21 years of follow‐up following the initial examination in 1968.Results. A low pulse‐wave amplitude (i.e. < 5 mm) during reactive hyperaemia was, independently of other known arteriosclerotic risk factors, associated with a higher cardiac event rate of 37.1% (relative risk: 2.2; 95% CI: 1.3–3.6) and a higher all‐cause mortality rate of 62.9% (relative risk: 1.7; 95% CI: 1.2–2.4) during 21 years of follow‐up. No other plethysmographically recorded variable was associated with an increased mortality and cardiac event rate.Conclusions. The plethysmographically recorded pulse‐wave amplitude during reactive hyperaemia can be used as an early independent marker to identify individuals at risk of developing ischaemic heart disease and death at an early age.