bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resting venous plasma adrenalin in 70‐year‐old men correlated positively to survival in a population study: the significance of the physical working capacity
Authors: Christensen N. J. , Schultz‐Larsen K. 
Published: August 2009

Abstract. Objective. The aim of the study was to evaluate plasma noradrenalin (NA) and plasma adrenalin (A) as predictors of mortality in a population study.Subjects. All subjects were 70 years of age in 1984. They were selected from the National Person Register. Altogether, 804 subjects participated in a comprehensive medical examination.Interventions. Plasma NA and A were measured in blood samples collected after the subjects had rested in the supine position for 15 min. The subjects have now been followed for 7 years.Main outcome measures. Seven years later, 115 men and 63 women had died.Results. Cox regression analysis showed that the mortality in the male group was positively correlated to plasma NA (P < 0.002) and inversely correlated to forced vital capacity (P < 0.0000) and plasma A (P < 0.02). A positive correlation was obtained between physical working capacity and plasma A. When an index of physical working capacity was included in the Cox regression analysis, both plasma NA and plasma A became insignificant, whereas a strong positive correlation appeared between physical working capacity and survival (P < 0.0000). Those who had low plasma A values in 1984 tended to die from cardiovascular diseases in the follow‐up period, whereas in those who died from cancer, plasma A values were similar to those of the general population.Conclusions. Subjects with high plasma A values had the best survival rate during the 7 year follow‐up period, probably because they also had the best physical working capacity. High plasma NA values, as expected, were associated with a reduced survival rate. Measurements of physical working capacity may be an inexpensive measure of probable survival in 70‐year‐old subjects.
Short‐term effects of eating on vasoactive hormones and haemodynamics in patients with heart failure
Authors: Berglund H. , Nyquist O. , Beermann B. , Jensen‐Urstad M. , Theodorsson E. 
Published: August 2009

Abstract. Objectives. To investigate if eating can influence the measurements of vasoactive hormones or their relationship to important haemodynamic variablesDesign. Haemodynamic variables and plasma concentrations of atrial natriuretic peptide (ANP), arginine vasopressin and angiotensin enzyme (ACE) activity were measured. During the 24‐h study period the patients ate ordinary hospital meals and thus were studied both in the absorptive and post‐absorptive phases.Setting. Two university hospitals in Sweden participated in the study.Subjects. Ten patients with heart failure, due to ischaemic heart disease.Intervention. Eating.Main outcome measures. Change in haemodynamic variables and plasma concentrations of vasoactive hormones related to eating.Results. After a meal (absorptive phase) pulmonary capillary wedge pressure and plasma concentrations of ANP were significantly lower compared to the postabsorptive phase, 13±1.7 vs. 16±1.9mmHg and 57±9.5 vs. 72±12.2 pmol I‐1, respectively. The relationship between ANP and its main predictor, pulmonary capillary wedge pressure, was not altered during the study period. Plasma concentration of arginine vasopressin, ACE activity and mean right atrial pressure decreased with time and the cardiac index increased with time over the study period.Conclusions. A meal may significantly influence plasma concentrations of ANP. Studies on vasodilator treatment and its interactions with ANP should take account of these basal fluctuations. The present data confirm previous reports on haemodynamic improvement during the first 24 h of supine cardiac catheterization in patients with heart failure, and add new information about decreasing concentrations of arginine vasopressin and ACE.
Synovectomy for haemophilic arthropathy: 6–21 years of follow‐up in 16 patients
Authors: Teigland J. C. , Tjønnfjord G. E. , Evensen S. A. , Charania B. 
Published: August 2009

Abstract. Objectives. To assess the efficacy of synovectomy in reducing recurrent haemarthroses and joint pain in patients suffering from haemophilic arthropathy. Moreover, to study whether synovectomy could improve joint mobility or postpone progression of joint destruction.Design. A retrospective study was conducted addressing joint‐related symptoms and findings, and the need of orthopaedic surgery during follow‐up.Setting. Oslo Sanitetsforenings Rheumatism Hospital/The National Hospital, the National Centre for Orthopaedic Surgery for approximately 180 Norwegians suffering from severe congenital coagulation deficiencies.Subjects. Twelve patients with haemophilia A, two patients with von Willebrand's disease and two patients with factor VII deficiency in which 21 synovectomies (nine knees. six ankles and six elbows) were performed.Main outcome measures. Joint pain, joint mobility, frequency of haemarthroses and radiographic joint scores at follow‐up were compared to preoperative figures, and the number of joints in need of total joint replacement or arthrodesis was evaluated.Results. Synovectomy proved efficacious in reducing recurrent haemarthroses and joint pain in all patients. The total range of motion was not improved, but correction of extension deficiency of the knee was accomplished. The progression of arthropathy was not arrested by synovectomy as judged by the radiographic assessment; and in four patients arthroplasty of the knee, and in two patients arthrodesis of the ankle, had been performed. A major wound haemorrhage and subsequent wound rupture was seen in one patient who developed high‐titred neutralizing antibodies to factor VIII.Conclusions. Synovectomy for haemophilic arthropathy is safe and efficacious in reducing recurrent haemarthroses and joint pain. Synovectomy should not be performed to improve joint mobility. The progression of the arthropathy is not arrested, and subsequently many patients will be candidates for arthroplasty or arthrodesis.
Systemic blood pressure and glomerular leakage with particular reference to diabetes and hypertension
Authors: Mogensen C. E. 
Published: August 2009

Both day and night blood pressure have considerable ranges in normal individuals and also in diabetic patients. In addition, there is considerable variation intra‐individually, with considerable excurses in blood pressure, e.g. during exercise, other daily activities as well as on exposure to medical personnel. There is good evidence to suggest that elevated blood pressure is an important factor in the progression of renal disease in diabetes, even from the initial phase of the slight elevation of the albumin excretion rate. From the earliest phase of microalbuminuria, blood pressure may increase by an average of 3–4 mmHg per year in contrast to 1 mmHg per year in healthy controls and in clearly normoalbuminuric individuals. Throughout the course of the complications of diabetes, both insulin‐dependent and non‐insulin‐dependent, there is a correlation between albuminuria and blood pressure in cross‐sectional studies; also there is a significant correlation between blood pressure and the progression of albuminuria. The same findings are available in essential hypertension and also to some extent in the background population, although in the latter the correlation between albuminuria and blood pressure is much less precise, although highly significant.Several trials conducted over the years uniformly show that antihypertensive treatment reduces albuminuria and, in many studies, progression in renal disease also, as measured by the glomerular filtration rate (GFR) fall. Therefore, it could be considered as a means to reduce blood pressure generally in diabetic individuals, even from the start of diabetes, with the aim of future further prevention of renal complications and possibly other complications. Such a proposal is less attractive in the background population because renal disease is much more rare. Another similar approach would be the prevention of increasing blood pressure in individuals at risk of renal disease, e.g. diabetics. Obviously, abnormalities in the vascular wall of a biochemical/functional nature may make diabetics more pressure‐sensitive, and the indication is that several other risk factors are involved, in particular poor metabolic control. Nevertheless, it is proposed that trials should be conducted very early in the course of diabetes, to see if the same positive effect can be obtained early as that documented later in the course of microalbuminaria and overt renal disease, both in insulin‐dependent and in non‐insulin‐dependent diabetes. In essential hypertension, antihypertensive treatment has a profound effect on albuminuria, and this may be associated with long‐term renoprotection, but this is less well documented.
Metformin and metoprolol CR treatment in non‐obese men
Authors: Landin K. , Tengborn L. , Smith U. 
Published: August 2009

Objective. To study the effect of metformin and metoprolol CR on insulin sensitivity, blood lipids, fibrinolytic activity and blood pressure.Design. A double‐blind, placebo controlled, triple cross‐over study with randomization to either metformin, 850 mg b.i.d., or metoprolol CR 100 mg o.d., or placebo for a period of 18 weeks. The glucose uptake was measured with the euglycaemic clamp technique after every 6 weeks' treatment period. Blood pressure and blood samples were taken every 3rd week.Subjects. Eighteen non‐obese men (53 ± 6 years of age).Results. Metformin decreased C‐peptide (P < 0.02), FFA (P < 0.003), total and low‐density lipoprotein cholesterol, tissue plasminogen activator antigen and the urinary potassium excretion (P < 0.05 for all), but not blood pressure compared to placebo. Metoprolol CR reduced diastolic blood pressure and pulse rate; fasting free fatty acids and the urinary potassium increased (P < 0.05 for all). No effect of metformin or metoprolol CR was seen on the glucose disposal rate, blood glucose, plasma insulin, triglycerides, high‐density lipoprotein cholesterol, lipoprotein(a), uric acid or plasminogen activator inhibitor 1 activity or antigen. The glucose uptake was not particularly decreased in these subjects.Conclusion. The study shows that metformin has some favourable effects on metabolism and that metoprolol CR is fairly neutral in this regard. The lack of effect of metformin on glucose disposal rate and blood pressure can be explained by the fact that the individuals studied were neither insulin resistant nor hypertensive. The data does not preclude an antihypertensive effect by treating a concomitant insulin resistance.
A 5‐year follow‐up study on the incidence of retinopathy in type 1 diabetes mellitus in relation to medical risk indicators
Authors: Agardh E. , Agardh C.‐D. , Torffvit O. 
Published: August 2009

Objectives. The aim of the present study was to describe the 5‐year incidence of retinopathy in type 1 diabetes mellitus and to characterize risk indicators for the development and progression of retinopathy.Design. A cross‐sectional study of type 1 diabetic patients taken care of at a medical department.Setting. All type 1 diabetic patients attending the Department of Internal Medicine, University Hospital, Lund, during a 2‐year period were offered ophthalmological examination.Subjects. A total of 396 out of 461 (85.9%) initially examined type 1 diabetic patients formed the basis for this 5‐year follow‐up study.Main outcome measures. The degree of retinopathy was based on fundus photography or biomicroscopy. Degree of metabolic control was assessed by HbA1c levels, signs of nephropathy by albumin creatinine clearance ratio and urinary albumin levels. Blood pressure was measured in the supine position. Duration of diabetes, age, and insulin dosage were registered.Results. The incidence of retinopathy was 47.2%, and progression from background to severe retinopathy occurred in 41%. Risk indicators for the development of retinopathy were duration of diabetes (P < 0.001), degree of metabolic control (P < 0.001), insulin dosage (P < 0.05) and signs of nephropathy based on measurements of albumin creatinine clearance ratio (P < 0.01) and urinary albumin concentration (P < 0.05). Two risk indicators could be identified for progression of retinopathy, i.e. the degree of metabolic control (P < 0.01) and diastolic blood pressure (P < 0.05).Conclusions. The results suggest that apart from poor metabolic control, development of retinopathy in type 1 diabetes is associated with long diabetes duration and clinical signs of diabetic nephropathy. Progression of retinopathy is associated with poor metabolic control and elevated diastolic blood pressure levels.
Diurnal changes in heparin effect during continuous constant‐rate infusion. A study in nine patients with venous thromboembolism
Authors: KRULDER J. W. M. , VAN DEN BESSELAAR A. M. H. P. , VAN DER MEER F. J. M. , MEINDERS A. E. , BRIËT E. 
Published: August 2009

Abstract. Objective. To evaluate the importance of diurnal variations in the effect of a continuous infusion of unfractionated heparin.Design. Twenty‐four‐hour follow‐up.Setting. Tertiary referral centre.Subjects. Patients (five male, four female) with acute venous thromboembolic diseases.Main outcome measures. Two‐hourly measurement of anti‐IIa activity, anti‐Xa activity, APTT (Cephotest and automated APTT), antithrombin III and cortisol for 24 h.Results. The maximum anticoagulant effect was found at 04.00–06.00 hours, and the minimum effect at 12.00 hours. The difference was 0.40 U ml‐1 for anti‐IIa activity (95% confidence interval (CI) 0.03–0.78; P < 0.05), 0.36 U ml‐1 for anti‐Xa activity (95% CI–0.05–0.72; not significant [NS]), 15.1 s for Cephotest APTT (95% CI 3.3–26.9; P < 0.03), and 112.9 s for automated APTT (95% CI 7.8–218.0; P < 0.05). Antithrombin III decreased from 97.9% at the start to 82.6% 24 h later (P = 0.001). Cortisol showed a typical diurnal rhythm. Expressed as a percentage of the individual 24‐h mean, a maximum was found at 04.00 hours (anti‐IIa activity), 06.00 hours (both APTTs), and 08.00 hours (anti‐Xa activity) and a minimum at 12.00 hours (all variables). The difference was 26% for anti‐IIa activity (P < 0.05) and anti‐Xa activity (NS), 22% for APTT (Cephotest; P < 0.03), and 44% for APTT (automated APTT; P < 0.05).Conclusions. A continuous intravenous infusion of unfractionated heparin has a maximum anticoagulant effect between 04.00 and 8.00 hours and a minimum effect at noon. For individual patients the moment of minimum and maximum effect varies widely. Because the most impressive changes occur between 06.00 and 08.00 hours, laboratory control can best be performed at fixed times, e.g. at 10.00 and at 22.00 hours.
Acupuncture versus metoprolol in migraine prophylaxis: a randomized trial of trigger point inactivation
Authors: HESSE J. , MØGELVANG B. , SIMONSEN H. 
Published: August 2009

Abstract. Objectives. To compare the effects of dry needling of myofascial trigger points in the neck region to metoprolol in migraine prophylaxis.Design. Randomized, group comparative study. patients, investigator and statistician were blinded as to treatment, the therapist was blinded as to results.Setting. Outpatient pain clinic in the northern Copenhagen area. Patients were referred by general practitioners or respondents to newspaper advertisements.Subjects. Included were patients with a history of migraine with or without aura for at least 2 years. Excluded were persons with contraindications against treatment with beta blockers, chronic pain syndromes, pregnancy or previous experience with acupuncture or beta‐blocking agents. A total of 85 patients were included; 77 completed the study.Interventions. After a 4‐week run‐in period, patients were allocated to a 17‐week regimen either with acupuncture and placebo tablets or to placebo stimulation and metoprolol 100 mg daily.Results. Both groups exhibited significant reduction in attack frequency (P < 0.01). No difference was found between the groups regarding frequency (P > 0.20) or duration (P > 0.10) of attacks, whereas we found a significant difference in global rating of attacks in favour of metoprolol (P < 0.05).Conclusions. Trigger point inactivation by dry needling is a valuable supplement to the list of migraine prophylactic tools, being equipotent to metoprolol in the influence on frequency and duration (but not severity) of attacks, and superior in terms of negative side‐effects.
Diabetic foot ulcers in a multidisciplinary setting An economic analysis of primary healing and healing with amputation
Authors: APELQVIST J. , RAGNARSON‐TENNVALL G. , LARSSON J. , PERSSON U. 
Published: August 2009

Abstract. Objectives. To perform an economic analysis of primary healing and healing with amputation in diabetic patients with foot ulcers.Design. A retrospective economic analysis based on a prospective study of consecutively presenting diabetic patients admitted to the Department of Internal Medicine because of foot ulcer.Setting. A multidisciplinary foot‐care team.Subjects. A total of 314 consecutively presenting diabetic patients with foot ulcers. Forty patients died before healing occurred. In those patients who healed primarily (n = 197) or after amputation (n = 77), a retrospective economic analysis was performed.Interventions. All patients were treated by a multi‐disciplinary foot care team consisting of diabetologist, orthopaedic surgeon, diabetes nurse, podiatrist and orthotist both as in‐ and out‐patients. The patients were followed by the team from admittance until final outcome, i.e. primary healing or healing with amputation or death.Main outcome measures. Data from both the prospectively collected patient material and from patient records were used to estimate the cost for hospital care, antibiotics, surgery, out‐patient care, staff attendance, drugs and material for ulcer dressings, and orthopaedic appliances.Results. The total costs were SEK 51000 (3000–808000) for patients with primary healing and SEK 344000 (27000–992000) for healing with amputation. Costs for in‐patient care were 37% of total average costs for primary healing and 82% for patients with amputation. The costs for topical treatment of the ulcers in out‐patient care were 45% of the total average cost for primary healed and 13% for patients who healed with amputation. The costs for products used for ulcer dressings were 21% of total costs for topical treatment, i.e. 9% and 3% of total average costs for primary healing and healing with amputation, respectively. Costs for visits to the foot care team, antibiotics and orthopaedic appliances were low in relation to total costs.Conclusion. Treatment of diabetic patients with foot ulcers in a multidisciplinary system was associated with relatively low costs. Healing with amputation was associated with high costs mainly due to multiple and extended hospitalization. These findings indicate the potential cost savings of preventive and multi‐disciplinary foot care.
Metabolic effects of isradipine as monotherapy or in combination with pindolol during long‐term antihypertensive treatment
Authors: LIND L. , BERNE C. , POLLARE T. , LITHELL H. 
Published: August 2009

Abstract. Design. Open long‐term study with parallel groups.Setting. Kungsgärdet Geriatric Hospital, Uppsala, a tertiary referral hospital.Subjects. Twenty‐six untreated hypertensive subjects.Interventions. After 4 weeks on placebo, isradipine was titrated up to 10 mg daily to achieve appropriate blood pressure control (n = 11). If this failed, 5–10 mg pindolol was added. The treatments were continued for 2 years.Main outcome measures. Blood pressure, lipoprotein measurements, intravenous glucose tolerance test, hyperinsulinaemic euglycaemic clamp, HbA***1c, body weight.Conclusions. The hypotensive effect of isradipine was sustained during long‐term use but was associated with weight gain and an impaired glucose control. When isradipine was combined with pindolol there was also a reduction in insulin sensitivity and an increase in VLDL triglycerides, possibly as effects of the beta‐adrenergic blockade.Objectives. To evaluate the effects of isradipine alone and in combination with pindolol on glucose and lipid metabolism during long‐term antihypertensive therapy.Results. Treatment with isradipine alone caused a sustained reduction in blood pressure (‐22/‐10 mm Hg, P < 0.01), but an increase in body weight (+ 2.2 kg, P < 0.05) and HbA***1c (+ 1.5%; P < 0.001) were also noted. Addition of pindolol resulted in a similar degree of blood pressure reduction and weight gain, whilst HbA***1c was less affected (+ 1.0%; P < 0.05, compared to isradipine alone). Insulin sensitivity became impaired in both groups (– 1.2 to – 1.5 mg kg‐1 min‐1; P < 0.01 for M‐value at hyperinsulinaemic clamp) but after adjustment for the change in body weight the impairment was only significant (P < 0.01) in the group with combined treatment. The combined treatment also resulted in an increase in very‐low‐density‐lipoprotein (VLDL) triglyderides (+ 0.37 mmol L‐1; P < 0.05).
Studies in hypertriglyceridaemia 1. Serum triglyceride distribution and its correlates in randomly selected Swedish middle‐aged men
Authors: ASPLUND‐CARLSON A. , CARLSON L. A. 
Published: August 2009

Abstract. Objectives. To obtain a randomly selected hypertriglyceridaemic population for detailed further characterization.Design. Study of randomly selected males.Setting. Subjects examined and blood sampled at Sollentuna Primary Health Care Centre.Subjects. Men aged 40–50 years (n = 1564), living in the Stockholm area, who were screened for hypertriglyceridaemia, January 1990‐June 1992.Main outcome measures. Fasting concentrations of serum triglycerides.Results. The serum triglyceride concentration distribution showed the expected skew distribution with the 90th and the 95th percentile at 2.51 and 3.05 mmol L‐1, respectively. The mean serum triglyceride level compared well with several population values reported from this laboratory over the last 30 years, indicating stable triglyceride levels over time. There was no significant age‐trend for the triglyceride concentration. Lower mean values for triglyceride, insulin and waist‐to‐hip (W/H) ratio were observed during the summer, whilst apolipoprotein A‐I levels were higher. There was a linear relation between the number of cigarettes smoked and the serum triglyceride concentration. In stepwise multiple linear regression analysis with the triglyceride concentration as the dependent variable the following variables appeared as significant (P < 0.01) contributors: insulin, cholesterol, glucose, apolipoprotein A‐I, number of cigarettes smoked, BMI, W/H ratio and diastolic blood pressure. The regression coefficient for apolipoprotein A‐I was negative; all the others were positive. The multiple regression (R) was 0.68, suggesting that up to 47% of the variation of the serum triglyceride concentration could be predicted by these factors.Conclusions. A group of randomly selected hypertriglyceridaemic men has been recruited for further clinical, metabolic and genetic studies. Basic characteristics of the population for their recruitment are described.