bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetes as a risk factor for myocardial infarction: population and gender perspectives
Authors: LUNDBERG V. , STEGMAYR B. , ASPLUND K. , ELIASSON M. , HUHTASAARI F. 
Published: August 2010

Abstract. Lundberg V, Stegmayr B, Asplund K, Eliasson M, Huhtasaari F (Kalix Hospital, Umel University Hospital and Lulei‐Boden Hospital, Sweden). Diabetes as a risk factor for myocardial infarction: population and gender perspectives. Objectives: To investigate diabetes as a risk factor for acute myocardid infarction (AMI) from a population perspective in a region with high cardiovascular disease (CVD) risk. Design: Population screenings for diabetes and a population‐based AMI register. Setting: Northern Sweden MONICA area. Subjects: Representative sample (Norrbotten and Vasterbotten counties) of 2432 men and women 35–64 years was investigated 1990 and 1994. All patients with AMI aged 35–64 years were included, in total 3031 between 1989 and 1993. Results: The prevalence of diabetes was 5% in men and 4.4% in women. The relative risk (RR) in diabetic men was 2.9; 95% coniidence interval (CI) 2.6‐3.4, and in diabetic women, RR 5.0: CI 3.9‐6.3. The risk for re‐infarction was about twice as large in patients with diabetes as in patients without diabetes. In both sexes the overall 28 day case fatality (CF) was significantly higher in diabetic compared to nondiabetic subjects. When compared to the non‐diabetic population, the overall mortality from AM1 in the diabetic population was 4 times higher among men and 7 times higher among women. The population attributable risk (PAR), a crude estimate of all AMIs attributable risk (PAR), a crude estimate of all AMIs women. Conclusions: Diabetes increases the risk for AM1 attack rate, incidence, case‐fatality, recurrence and mortality and is an important contributor to all AMIs in middle‐aged people.
Enhancement of B‐cell secretion by blood glucose normalization in type 2 diabetes is associated with fasting C‐peptide levels
Authors: CLAUSON P. , ALVARSSON M. , GRILL V. 
Published: August 2010

Abstract. Clauson P, Alvarsson M, Grill V (Karolinska Hospital, Stockholm, Sweden). Enhancement of B‐cell secretion by blood glucose normalization in type 2 diabetes is associated with fasting Cpeptide levels. Objectives: To investigate (i) the variability of beneficial effects achieved by short‐term near‐normalization of blood glucose in type 2 diabetes patients, and (ii) the relationship of beneficial effects to individual characteristics of diabetes. Design: Arginine‐induced insulin and glucagon release tested at two glucose levels before and alter 3 days of intensive insulin treatment. Setting: The Department of Endocrinology and Diabetology, Karolinska Hospital, Stockholm, Sweden. bolic control sampled from an area‐based population of diabetes patients. Results: Levels of fasting blood glucose declined from 15.0 f 0.9 to 8.5 k 0.7 mmol L‐‘, Cpeptide from 0.81 f 0.06 to 0.49 & 0.05 nmol L‐’ and percent proinsulin (of total IRI) from 7.8 & 1.0 to 3.2 f 0.6%. At comparable glucose levels arginine‐induced insulin secretion was enhanced 46.3+19.5% (range ‐36 to 220%). Enhancement correlated with extent of blood glucose normalization and also with fasting Gpeptide levels and with overweight. Arginineinduced glucagon secretion was nonsignificantly depressed (17.2 f 7.4%, range ‐ 59 to 29%). Insulin sensitivity assessed by M: I ratio was increased by a median of 95 %. Conclusions: In type 2 diabetes patients reversibility type 2 diabetes patients reversibility function is variable. Variability is related to B‐cell mass in individual patients with type 2 diabetes.
Adults with childhood‐onset growth hormone deficiency: effects fo growth harmone treatment on cardiac structure
Authors: SARTORIO A. , FERRERO S. , CONTI A. , BRAGATO R. , MALFATTO G. , LEONETTI G. , FAGLIA G. 
Published: August 2010

Abstract. Sartorio A, Perrero S, Conti A, Bragato R, Malfatto G, Leonetti G, Faglia G. (Laboratorio Sperimentale di Ricerche Endocrinologiche, Istituto AuxoIogico Italiano, Milano, Italy). Adults with childhood‐onset growth hormone deficiency: effects of growth hormone treatment on cardiac structure. Objectives: To evaluate the effects of growth hormone deficiency (GHD) and of growth hormone (GH) therapy on cardiac structure in adults with child‐hood‐onset GHD. Settiig: Out‐patient clinic in the Italian Institute for Auxology, Milan. Subjects: Eight adults with childhood‐onset GHD and eight healthy controls, matched for sex, age, exercise and body mass index. Interventions: Recombinant GH (Saizen Serono, Italy), administered in a conventional dose of 0.5 IU kg‐1 week‐1 for 6 months. Main outcome measures: Cardiac structure parameters, evaluated by two‐dimensional, M‐mode and Doppler echocardiograms, and stress test, by means of a modified Bruce protocol with a bicycle ergometer, were determined before and after 6 months GH therapy. Results: Before treatment, mean (±SE) intraventricular septal thickness (IVST: 7.1 ± 0.2 mm), LV posterior wall thickness (LVPT: 5.2± 0.1 mm), LV mass(LVM: 94.6 ± 5.0 g), LV massindex (LVM/body surface area, LVMI: 65.1 ± 3.0 g m‐2) and left ventricular end‐diastolic diameter (LVED 41.4 ± 0.6 mm) of patients were significantly lower (P< < 0.01) than in controls, whilst LV end‐systolic diameter (LVES) of patients (25.5 ± 0.7 mm) was similar to controls (27.5 ± 0.7). GH treatment significantly (P < 0.01) increased LWT (6.8 ± 0.2 mm), LVM (111.6 ± 4.6 g) and LVMI (80.5 ± 3.5 gm‐2): no sigdcant changes were observed in LVED, LVES and IVST values. The stress test showed a significant improvement of cardiac performance, as demonstrated by the reduction of blood pressure x heart rate product at the same workload (basal: 32722.5 ± 897.4 vs. after: 25574.6 ± 439.7). Conclusions: GH plays a role in the maintenance of a normal cardiac structure in adulthood. The present study suggests that GH treatment might be able to improve the cardiac structure of patients with childhood‐onset GHD.
No difference in blood thiamine diphosphate levels between Swedish Caucasian patients with congestive heart failure treated with furosemide and patients without heart failure
Authors: YUE Q.‐Y. , BEERMANN B. , LINDSTRÖM B. , NYQUIST O. 
Published: August 2010

Abstract. Yue Q‐Y, Beermann B, Lindstrom B, Nyquist 0 (Huddinge University Hospital, Huddinge, and the Medical Product Agency, Uppsala, Sweden). No difference in blood thiamine diphosphate levels between Swedish Caucasian patients with congestive heart failure treated with furosemide and patients without heart failure. Intern Med 1997; 242:49 1‐49 5.Objectives: To determine whether furosemide treatment in congestive heart failure (CHF) patients is associated with thiamine deficiency.Design: Patients without heart failure and without diuretic treatment were included to compare with patients with CHF belonging to New York Heart Association (NYHA) functional class I1 and 111‐IV, respectively, and receiving furosemide therapy.Setting: All patients were recruited from the emergency ward of the cardiology section, Huddinge University Hospital, where they were admitted due to CHF or acute myocardial infarction.Subjects: Ninety‐nine patients were included from whom a blood sample was taken, as well as routine admission blood samples for the analysis of thiamine diphosphate (TPP)concentrations: Patients taking vitamin preparations were excluded.Main outcome measures: Blood TPP concentrations were measured by high performance liquid chromatography (HPLC) and compared between the patient groups by the use of ANOVA.Results: No significant difference was found between the groups in blood TPP concentrations.Conclusions: Thiamine deficiency may not be a complication of furosemide treatment in the studied Swedish patient population.
Bone mass and riks factors for bone los in perimenopausal Danish women
Authors: BROT C. , JENSEN L. B. , SØRENSEN O. H. 
Published: August 2010

Abstract. Brot C, Jensen LB, Smensen OH (Copenhagen Municipal Hospital, Copenhagen, Denmark). Bone mass and risk factors for bone loss in perimenopausal Danish womenObjectives: To determine risk factors for low bone mass at menopause and risk factors for subsequent bone loss in the following period.Design: A cross‐sectional study and a 2‐year prospective follow‐up.Setting: The catchment area of Sundby Hospital in Copenhagen.Subjects: Four hundred and thirty‐three women aged 45–58 years, with amenorrhea for 3–24 months, of whom 87 were followed for a 2‐year period.Measurements: Registration of life‐style and anthropometric variables, reproductive history, and family history of fractures. Total body bone mineral content (BMC) was measured with dual energy X‐ray absorptiometry.Results: By means of multiple regression analysis height, body weight, and length of reproductive period were found to be positively related to whole body BMC (P < 0.001), whilst a negative relationship was found to age (P < 0.001), smoking (P < 0.001), and family history of fractures (P < 0.005).In the longitudinal study, only body weight at the inclusion (P = 0.005) and subsequent changes in body weight and fat mass (P < 0.001) were related to the changes in bone mass.Conclusion: The most significant predictors for bone loss were changes in body weight and fat mass. Hence, weight loss is a risk factor for bone loss in the early postmenopausal period, whereas weight gain seems to preserve bone.
Ethical aspects of clinical trials: the attitudes of participants in two non‐cancer trials
Authors: Madsen S. M. , Holm S. , Davidsen B. , Munkholm P. , Schlichting P. , Riis P. 
Published: August 2010

Abstract. Madsen SM, Holm S, Davidsen B, Munkholm P, Schlichting P, Riis P (Copenhagen University Hospital in Herlev, Slagelse County Hospital, Slagelse, Hvidovre Hospital, University of Copenhagen, Denmark and University of Manchester, UK). Ethical aspects of clinical trials: the attitudes of participants in two non‐cancer trials. J Intern Med 2000; 248: 463–474.Objectives. To investigate attitudes to clinical trials in non‐cancer trial participants.Design. Questionnaires at entry, during, and after participation in a clinical study.Setting. Participants in: (i) ROC: a clinical study comparing systemic interferon‐α‐2A treatment vs. prednisolone enemas in ulcerative colitis; and (ii) MRCRUC: a clinical study investigating low‐field magnetic resonance imaging as a new modality for the evaluation of patients with inflammatory bowel disease.Subjects. Thirty‐two patients in ROC and 47 patients in MRCRUC.Outcome measures. Attitudes towards different aspects of clinical research.Results. The majority found scientific testing of clinical methods necessary, having positive attitudes towards both participation by themselves and others. The creation of a personal moral problem by denying participation was rejected by a large majority, and still both personal and altruistic motives for participation were highly rated. An important motive for accepting inclusion was the expectation of being ‘a special patient’ during the trial. The presence of research ethics committees controlling clinical research had a significant positive impact on decisions to participate, and drawing lots and blinding were found problematic by only a minority. Patients valued their satisfaction with participation in the trials highly, and would almost all accept a request to participate in future trials. The most important reason for this was a feeling of receiving better care and information than expected outside a trial setting, primarily determined by the patients seeing only one physician during the trials. A pronounced wish to obtain follow‐up information was expressed.Conclusion. Attitudes towards medical research are positive with both altruistic and nonaltruistic motives for participation. Expectations of being treated as ‘a special patient’ in the trial were important in accepting to participate. Seeing the same physician at control visits was an important factor for satisfaction with participation.
Cardiovascular disease and risk factors in persons with  type 2 diabetes diagnosed in a large population screening:  The Nord‐Trøndelag Diabetes Study, Norway
Authors: Claudi T. , Midthjell K. , Holmen J. , Fougner K. , Krüger Ø. , Wiseth R. 
Published: August 2010

Abstract. Claudi T, Midthjell K, Holmen J, Fougner K, Krüger Ø, Wiseth R (University of Tromsø/Rønvik Health Center, Bodø; National Institute of Public Health, Community Medicine Research Unit, Verdal; University Hospital of Trondheim; and Norwegian University of Science and Technology, Trondheim, Norway). Cardiovascular disease and risk factors in persons with type 2 diabetes diagnosed in a large population screening: The Nord‐Trøndelag Diabetes Study, Norway. J Intern Med 2000; 248: 493–501.Objective. To study cardiovascular status and risk factors in persons with newly diagnosed type 2 diabetes and controls in a large population.Design. Case–control study.Setting. Population screeningSubjects. The screening of 74 499 individuals (88.1%), aged 20 years and older, in Nord‐Trøndelag County, Norway, during 1984–86 detected 428 persons with undiagnosed diabetes according to the 1980 WHO criteria, of whom 205 attended a clinical follow‐up examination assessing cardiovascular status and risk factors.Methods. For each of 205 cases, one control person matched by age and sex underwent the same clinical examination. Lipids, body mass index, waist/hip ratio, blood pressure, pulse rate, blood pressure medication, kidney function, cardiovascular disease, family history and lifestyle were recorded.Results. At the screening prior to the diagnosis of diabetes, those with diabetes reported poorer general health, less physical activity, more siblings with diabetes and more frequent use of antihypertensive medication. They had higher body mass index, systolic and diastolic blood pressure and pulse rate compared with controls. At the clinical evaluation, diabetics had higher urine albumin levels, increased waist/hip ratio, and higher total cholesterol/HDL cholesterol ratios than the controls. They also reported a greater incidence of angina pectoris and had more ECG changes.Conclusions. Diabetics presented with more cardiovascular risk factors, angina pectoris and ECG changes than the controls, and they had an established metabolic syndrome more often than controls. These results suggest that prevention of cardiovascular disease in diabetics requires earlier diagnosis of the diabetes.
A role for transoesophageal echocardiography in the early diagnosis of catastrophic antiphospholipid syndrome
Authors: Zakynthinos E. G. , Vassilakopoulos T. , Kontogianni D. D. , Roussos C. , Zakynthinos S. G. 
Published: August 2010

Abstract Zakynthinos EG, Vassilakopoulos T, Kontogianni DD, Roussos C, Zakynthinos SG (Department of Critical Care and Pulmonary Services, University of Athens Medical School, ‘Evangelismos’ Hospital, Athens, Greece). A role for transoesophageal echocardiography in the early diagnosis of catastrophic antiphospholipid syndrome (Case Report). J Intern Med 2000; 248: 521–526.We describe a previously healthy 28‐year‐old woman who presented with the clinical picture of large vessel occlusions (stroke with left hemiparesis, myocardial infarction) and developed multi‐organ failure (i.e. kidneys, heart, brain, liver, blood, skin) over a very short period of time. Peripheral blood smear was consistent with thrombotic thrombocytopenic purpura. Transesophageal echocardiogram was supportive of the diagnosis of catastrophic antiphospholipid syndrome (CAPS), revealing Libman–Sacks endocarditis. Blood cultures were negative, anticardiolipin antibodies were highly increased and lupus anticoagulant was positive. Cerebral and coronary angiograms were negative, suggesting possible microthrombotic occlusive disease in the setting of CAPS.
Prevention of cardiovascular disease and diabetes: lessons from the Malmö Preventive Project
Authors: Nilsson P. , Berglund G. 
Published: August 2010

Abstract. Nilsson P, Berglund G (University Hospital, Malmö, Sweden). Prevention of cardiovascular disease and diabetes – lessons from the Malmö Preventive Project (Review). J Intern Med 2000; 248: 455–462.Major public health problems such as cardiovascular disease and type 2 diabetes pose a challenge to both the medical profession and the health care system of most Western countries. In spite of widespread knowledge about risk factors and pathophysiological processes, it has been difficult to find effective preventive mass strategies based on evidence from controlled clincial trials. In the Malmö Preventive Project, Sweden, 33 346 subjects were screened for risk factors between 1974 and 1992, and a quarter of them were offered preventive help for cardiovascular disease risk or alcohol abuse. The overall finding of the project was that benefits of screening and prevention on mortality risk could only be shown in certain subgroups of younger men and women, not in the total screened cohort, as compared with a nonscreened reference population. These findings therefore question the effectiveness of preventive methods and drugs used during previous decades. New preventive methods are therefore needed and should be properly evaluated to form a basis for evidence‐based prevention (EBP) in cardiovascular medicine.
Cardiovascular disease in type 2 diabetes: challenge for treatment and prevention
Authors: Laakso M. 
Published: August 2010

Abstract. Laakso M (University of Kuopio, Kuopio, Finland). Cardiovascular disease in type 2 diabetes: challenge for treatment and prevention (Review). J Intern Med 2001; 249: 225–235.Type 2 diabetes increases the risk of cardiovascular disease (CVD) two‐ to fourfold compared with the risk in non‐diabetic subjects. Although type 2 diabetes is associated with a clustering of risk factors (small, dense low‐density lipoprotein [LDL] particles, low high‐density lipoprotein [HDL] cholesterol, high triglycerides, elevated blood pressure, obesity, central obesity, hyperinsulinaemia, hyperglycaemia, etc.), the cause for an excess risk of CVD remains unknown. Recent drug treatment trials have indicated that the lowering of total and LDL cholesterol and blood pressure is similarly beneficial in diabetic and non‐diabetic subjects. The treatment of hyperglycaemia reduces micro‐ and macrovascular complications in type 2 diabetic patients. Beta‐blocking agents, angiotensin‐converting enzyme inhibitors, aspirin, and thrombolytic therapy are also effective in the treatment of CVD amongst diabetic patients.
Blood pressure in diabetic nephropathy – current controversies
Authors: Ritz E. , Rychlík I. , Schömig M. , Wagner J. 
Published: August 2010

Abstract. Ritz E, Rychlík I, Schömig M, Wagner J (Department of Internal Medicine, Ruperto Carola University, Heidelberg, Germany). Blood pressure in diabetic nephropathy – current controversies (Review). J Intern Med 2001; 249: 215–223.Hypertension has been recognized as an early and constant feature of diabetic nephropathy, but recent studies also suggest that a genetic predisposition to hypertension is an important risk factor for diabetic nephropathy. Antihypertensive treatment attenuates progression in diabetic nephropathy, but there is increasing evidence that very early treatment and very low target blood pressures should be implemented. There is also evidence for local activation of the renin system in the kidney as a result of hyperglycaemia. Apart from blood pressure, proteinuria should be monitored and dosing of ACE inhibitors should be guided, also by reduction of protein excretion.
Metaiodobenzylguanidine (MIBG) scintigraphy and computed tomography (CT) in clinical practice. Primary and secondary evaluation for localization of phaeochromocytomas
Authors: Berglund A. Scott , Hulthén U. L. , Manhem P. , Thorsson O. , Wollmer P. , Törnquist C. 
Published: August 2010

Abstract. Scott Berglund A, Lennart Hulthén U, Manhem P, Thorsson O, Wollmer P, Törnquist C (Malmö University Hospital, Malmö, Sweden). Metaiodobenzylguanidine scintigraphy and computed tomography in clinical practice. Primary and secondary evaluation for localization of phaeochromocytomas. J Intern Med 2001; 249: 247–251. Objective. To determine the diagnostic value of metaiodobenzylguanidine (MIBG) scintigraphy compared with computed tomography (CT) for the localization of phaeochromocytomas in clinical practice. Design. Retrospective comparison between MIBG scintigrams and CT for localization of phaeochromocytomas in all patients successively examined with MIBG scintigraphy in Malmö from 1984 until January 1997. Setting. Malmö University Hospital, Sweden. Subjects. Sixty‐four patients with clinically suspected phaeochromocytomas. Main outcome measures. MIBG scintigrams and CTs classified as positive or negative based on original interpretations (primary evaluation) and in a secondary evaluation by one blinded examiner are assessed through histological confirmation or clinical rule out of phaeochromocytomas. Results. Twenty‐five patients had surgically removed phaeochromocytomas. The remaining 39 patients had no proof of phaeochromocytomas. In the secondary evaluation, sensitivity for MIBG scintigraphy was 88% (22/25) and for CT was 100% (25/25). The specificity for MIBG scintigraphy was 89% (35/39) but only 50% for CT (18/36). Two out of a total of six extra‐adrenal tumours were amongst the false‐negative MIBG scintigrams. Conclusions. MIBG scintigraphy for the localization of phaeochromocytomas is superior to CT as far as specificity, whereas CT has a higher sensitivity. After biochemical diagnosis, CT will detect most phaeochromocytomas. MIBG scintigraphy can be of value in patients who show inconclusive results with biochemical testing and CT.
Should patients with hypertension receive antithrombotic therapy?
Authors: Lip G. Y. H. , Edmunds E. , Beevers D. G. 
Published: August 2010

Abstract. Lip GYH, Edmunds E, Beevers DG (City Hospital, Birmingham, UK). Should patients with hypertension receive antithrombotic therapy? (Review). J Intern Med 2001; 249: 205–214.The main complications of hypertension, i.e. coronary heart disease, ischaemic strokes and peripheral vascular disease (PVD), are usually related to thrombosis. Increasing evidence also suggests that hypertension fulfils the components of Virchow’s triad, thus conferring a prothrombotic or hypercoagulable state, as evident by abnormalities of haemostasis, platelets and endothelial function. It therefore seems plausible that use of antithrombotic therapy may help prevent these thrombosis‐related complications of hypertension.Indeed, hypertensive patients with an estimated 10‐year CHD risk ≥ 15% will have their cardiovascular risk reduced by 25% using antihypertensive treatment, but the addition of aspirin further reduces major cardiovascular events by 15%. Recent guidelines recommend the use of aspirin 75 mg daily for hypertensive patients who have no contraindication to aspirin, in one of the following categories: (i) secondary prevention – cardiovascular complications (myocardial infarction, angina, non‐haemorrhagic stroke, peripheral vascular disease or atherosclerotic renovascular disease); and (ii) primary prevention – those with blood pressure controlled to < 150/90 mmHg and one of: (a) age ≥ 50 years and target organ damage (e.g. LVH, renal impairment, or proteinuria); (b) a 10‐year CHD risk ≥ 15%; or (c) type II diabetes mellitus. However, some of the risks of aspirin administration, namely increased incidence of major bleeding events, may possibly outweigh the benefits, especially in low‐risk individuals.