bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endogenous digoxin‐like factor in acute myocardial infarction
Authors: Bagrov A. Y. , Kuznetsova E. A. , Fedorova O. V. 
Published: August 2009

Abstract. Objectives. The aim of the study was to test the hypotheses that the concentrations of endogenous digoxin‐like factor (EDLF) are (i) increased in the initial period after acute myocardial infarction (AMI) and (ii) may contribute to the genesis of ventricular arrhythmias.Design. Consecutive sample study.Setting. An 800‐bed city teaching hospital, primary hospitalized care centre.Subjects. Fifty‐four consecutive patients of both sexes with a first transmural AMI, 16 male patients with unstable angina pectoris and eight healthy subjects.Interventions. None.Main outcome measures. Time‐course of the changes of plasma concentrations of EDLF (DELFIA digoxin fluoroimmunoassay) in patients during days 1–14 after uncomplicated AMI and AMI complicated with ventricular fibrillation and congestive heart failure.Results. Plasma concentrations of EDLF in patients on the 1st day after AMI were increased (1.25 ± 0.26 ng ml‐1 digoxin equivalents, P < 0.025) as compared with both healthy controls (0.34 ± 0.06 ng ml‐1) and patients with unstable angina pectoris (0.40 ± 0.08 ng ml‐1). On the 1st day after AMI the plasma levels of EDLF in seven patients with primary ventricular fibrillation were higher (2.54 ± 0.67 ng ml‐1, P < 0.05) than in 47 patients without ventricular fibrillation (1.05 ± 0.27 ng ml‐1). In 14 patients with AMI and congestive heart failure (class III. Killip), plasma concentrations of EDLF were significantly lower (0.32 ± 0.09 ng ml‐1, P < 0.01) than in 40 patients with AMI without congestive heart failure (1.51 ± 0.32 ng ml‐1). Starting from the 2nd day of AMI, plasma EDLF decreased to the level of the control values (0.35 ± 0.04 ng ml‐1) and did not change during a 2‐week period of observation.Conclusions. The results show an increase of plasma EDLF during the 1st day after AMI, and that higher plasma EDLF may be associated with the development of ventricular arrhythmias.
Familial hypercholesterolaemia‐like syndrome with apolipoprotein E‐7 associated with marked Achilles tendon xanthomas and coronary artery disease: a report of two cases
Authors: Ueyama Y. , Nozaki S. , Yanagi K. , Hiraoka H. , Nakagawa T. , Sakai N. , Jiao S. , Yamashita S. , Matsuzawa Y. 
Published: August 2009

Abstract. We observed two patients with hypercholesterolaemia and tendon xanthomas associated with apolipoprotein (apoE‐7) E‐7, a rare variant of the apoE isoforms. Both suffered from coronary artery disease and had undergone a coronary bypass operation. Their cholesterol levels were 268 and 310 mg dl‐1, respectively. Both patients had marked xanthomas in the Achilles tendons. Both also suffered from diabetes. Although their clinical and laboratory findings were compatible with typical familial hypercholesterolaemia (FH), the analysis of low‐density lipoprotein (LDL) receptors in cultured fibroblasts showed no abnormality of binding, internalization or degradation of 125I‐LDL.Diabetic control with a low‐calorie, low‐fat diet led to the rapid reduction of serum cholesterol. Other family members of the patients with apoE‐7, who were normoglycaemic, showed normal cholesterol levels and no xanthomas. These findings suggest that coexistent diabetes mellitus may induce overt hyperlipidaemia and accumulation of lipids in tissues in subjects with apoE7.
The role of diabetes mellitus and hypertriglyceridaemia as coronary risk factors in treated hypertension: 15 years of follow‐up of antihypertensive treatment in middle‐aged men in the Primary Prevention Trial in Göteborg, Sweden
Authors: Samuelsson O. , Hednert T. , Persson B. , Andersson O. , Berglund G. , Wilhelmesen L. 
Published: August 2009

Abstract.Objective. To analyse the importance of diabetes mellitus and hypertriglyceridaemia as potential risk factors for coronary heart disease (CHD) in middle‐aged, treated hypertensive men.Design. A prospective, long‐term observational studySubjects. Derived from a random population sample—686 hypertensive men aged 47–54 years at entry—followed for 15 years at a special out‐patient hypertension clinic.Intervention and outcome measures. The patients were mainly treated with beta‐adrenoceptor blockers and/or thiazide diuretics. Cardiovascular morbidity was closely monitored during follow‐up.Results. In all, 133 subjects suffered a CHD event during follow‐up. The presence of diabetes mellitus at entry more than doubled the CHD risk and a 1 mmol I‐1increment of the serum triglyceride level at entry increased the CHD risk by 21%. In multivariate analyses, smoking, the presence of diabetes mellitus at entry, serum cholesterol and signs or symptoms of hypertensive end organ damage were found to be independent risk factors for CHD. In absolute terms the existence of cardiovascular damage was of much greater prognostic importance than were the presence of various metabolic abnormalities. Of the mean in‐study variables, both the average serum cholesterol level and the achieved diastolic blood pressure were significantly associated with CHD. However, new diabetes mellitus which developed during follow‐up as well as mean serum triglyceride levels were not associated with CHD.Conclusions. Diabetes mellitus and hypertriglyceridaemia present at the start of treatment have a prognostic impact in treated hypertensive men, whereas when such metabolic disorders develop during drug treatment they seem to be of much less importance. Smoking and already existing evidence of hypertensive end organ damage are of utmost importance for the prognosis in this type of patient.
Egg consumption and high‐density‐lipoprotein cholesterol
Authors: Schnohr P. , Thomsen O. Ø. , Hansen P. Riis , Boberg‐Ans G. , Lawaetz H. , Weeke T. 
Published: August 2009

Abstract. Objectives. To examine if increased egg consumption raises serum high‐density‐lipoprotein (HDL) cholesterol in healthy individuals.Design. A cross‐over study.Setting. A private clinic for preventive health examinations in Copenhagen.Subjects. Twenty‐four healthy adults, 12 men and 12 women, aged 23–52 (median 40) years.Interventions. After a 1‐week control period each person added two bolled eggs to the usual daily diet for 6 weeks. All persons were instructed not to change the lifestyle in other ways during the whole study period.Main outcome measures. Serum HDL cholesterol, total cholesterol and triglycerides were measured before, during and after 6 weeks of extra egg consumption. The corresponding serum Iow‐density‐lipoprotein (LDL) cholesterol was calculated from the Friedewald formula.Results. After 6 weeks of extra egg consumption serum HDL cholesterol increased by 10% (P < 0.05) and total cholesterol increased 4% (P < 0.05), whereas the ratio total cholesterol/HDL cholesterol did not change significantly. Serum triglycerides and LDL cholesterol were also unchanged.Conclusions. A moderate egg intake should not be rigorously restricted in healthy individuals.
Insulin treatment improves microalbuminuria and other cardiovascular risk factors in patients with type 2 diabetes mellitus
Authors: Lindström T. , Olsson A. G. , Von Schenck H. , Wallentin L. , Arnqvist H. J. 
Published: August 2009

Abstract. Objectives. Insulin treatment of patients with type 2 diabetes causes hyperinsulinaemia and improves glycaemic control. We have studied how this affects risk factors for cardiovascular disease.Design. Patients with secondary failure to oral hypoglycaemic agents were studied whilst still taking oral agents and after insulin treatment for 8 weeks in an open study.Setting. Department of Internal Medicine, University Hospital, Linköping.Subjects. Ten consecutive patients with type 2 diabetes and secondary failure to oral hypoglycaemic agents.Interventions. Switching oral treatment to insulin treatment.Main outcome measures. Effect on several cardiovascular risk factors.Results. Fasting and postprandial plasma insulin concentrations were increased by insulin treatment whereas C‐peptide concentrations were lowered. HbAlc was reduced from 8.9 ± 0.3% (mean ± SEM) to 6.3±0.2% after 8 weeks. There was a weight gain of 2.8±0.7 kg. Plasma concentrations of total‐ and very‐low‐density‐lipoprotein (VLDL) cholesterol, VLDL‐, low density lipoprotein and high‐density‐lipoprotein triglycerides were all reduced. The plasma concentration of apolipoprotein B was also lowered. Tissue plasminogen activator antigen measured after venous occlusion showed a significant reduction whilst plasminogen activator inhibitor 1 activity was 26.0±9.8 IU ml‐1 on oral treatment and 18.2±4.7 IU ml‐1 on insulin treatment (NS). Albumin excretion in the urine was reduced and the percentage reduction correlated with the percentage lowering of the tissue plasminogen activator antigen concentration after venous occlusion but not with the percentage change of basal tissue plasminogen activator antigen concentration.Conclusions. Insulin treatment of patients with type 2 diabetes and secondary failure to oral hypoglycaemic agents causes hyperinsulinaemia and improves or has no unfavourable effect on several cardiovascular risk factors.
The epidemiology of a coronary waiting list A description of all of the patients
Authors: Bengtson A. , Herlitz J. , Karlsson T. , Hjalmarson A. 
Published: August 2009

Abstract.Objectives. To describe the characteristics and the severity of symptoms amongst patients on the waiting list for possible coronary revascularization.Design. All the patients were sent a postal questionnaire for symptom evaluation.Setting. All hospitals in western Sweden.Subjects. All patients in western Sweden on the waiting list in September 1990, who had been referred for coronary angiography or revascularization (n = 904) and a sex‐ and age‐matched reference group (n= 809).Results. More than half of the patients had daily attacks of chest pain, whereas 16% reported less than one attack per week or no pain at all. However, other symptoms such as dyspnoea, tachycardia and nervous reactions were also common and 25% of all patients used sedatives. A long waiting time for a given procedure was not associated with more pain but with more nervous symptoms such as restlessness and insomnia (P< 0.0001) and greater use of sedatives and cigarettes (P< 0.05).Conclusions. We conclude that a long waiting time for possible coronary revascularization is associated with more nervous symptoms but not with more pain.
Continuous infusion of furosemide in the treatment of patients with congestive heart failure and diuretic resistance
Authors: Van Meyel J. J. M. , Smits P. , Dormans T. , Gerlag P. G. G. , Russel F. G. M. , Gribnau F. W. J. 
Published: August 2009

Objectives. To assess the value of treatment with continuous intravenous infusion of furosemide (F) in patients with refractory congestive heart failure.Design. Open uncontrolled dose‐response study.Subjects. Patients with congestive heart failure (those with New York Heart Association (NYHA) classes III and IV with an assessed amount of oedema of more than 5 kg and diuretic resistance were included [n = 10]). Diuretic resistance was defined as: failure to lose weight and/or inappropriate urinary sodium excretion (50 mmol 24 h‐1) despite bed rest for a period of 2–3 days, salt and water restriction, orally and intravenously administered furosemide in a dose of 250 mg day‐1, digoxin, and when possible an ACE inhibitor. Included patients were treated with continuous F infusion at a delivery rate of 20 mg‐1 over 24 h. The infusion rate was gradually heightened up to a maximum dose of 160 mg h‐1.Main outcome measures. Daily physical examination, history of side‐effects, determination of serum electrolytes and 24‐h electrolyte excretion during treatment with furosemide.Results. Weight loss (mean ± sd; 12.5 ± 5 kg) and relief of symptoms was achieved in all patients. Mean (± sd) 24‐h sodium output rose from 19 ± 16 mmol 24 h‐1 (n = 10) on oral therapy with 250 mg F to 137 ± 85 mmol 24 h‐1 (n = 8) during 80 mg h‐1 and to 268 ± 124 mmol 24 h‐1 (n = 3) on the maximal dose of 160 mg h‐1.Conclusion. Continuous infusion of F under careful monitoring of the patient is a safe, controllable and efficient treatment in patients with severe congestive heart failure and diuretic resistance.
The changes in blood pressure after acute stroke: abolishing the ‘white coat effect’ with 24‐h ambulatory monitoring
Authors: Harper G. , Fotherby M. D. , Panayiotou B. J. , Castleden C. M. , Potter J. F. 
Published: August 2009

Objectives. To assess the changes in 24‐h and casual blood pressure (BP) levels following hospitalization for acute stroke.Design. Prospective study of patients admitted with acute hemispheric stroke and hospitalized controls using casual and 24‐h BP monitoring.Setting. Medical wards in a large teaching hospital.Subjects. Thirty‐three patients (median age 77 years, 17 male) and 21 control subjects admitted non‐acutely.Interventions. All subjects underwent 24‐h BP monitoring within 24 h of stroke onset (patients) or admission (controls) and again at 1 week. Casual BPs were recorded over the same period.Main outcome measures. The change in BP over the first week in each group. Eleven stroke subjects had 24‐h BP monitoring repeated at 6 months.Results. In the stroke group, 24‐h systolic BP (SBP) fell by 7 mmHg (95% CI, 0 to 14 mmHg; P < 0.05) and diastolic BP (DBP) by 3 mmHg (95% CI, 0 to 6 mmHg; P < 0.02) over the first week. Mean 24‐h BP levels in the control group did not change during this period. However, casual BP recordings fell in both stroke (18/12 mmHg) and control (19/9 mmHg) groups. Stroke subjects followed to 6 months showed no further change in 24‐h BP (day 7: 137±17/79±13 mmHg; month 6: 138 ± 16/78 ± 11 mmHg).Conclusions. Although there was a large fall in causal BPs seen in both groups there, was only a small, but a significant fall in mean 24‐h BP over the first week following hemispheric stroke that was not seen in control subjects. Although the ‘white coat effect’ and admission to hospital play an important part in the high casual BP observed in the days following acute stroke they are unlikely to be the sole factors.
Relation of maternal blood pressure during pregnancy to birth weight and blood pressure in children. The Hypertension in Pregnancy Offspring Study
Authors: Himmelmann A. , Svensson A. , Hansson L. 
Published: August 2009

Objective. To evaluate the importance of perinatal factors, e.g. low birth weight, reduced gestational period and elevated maternal blood pressure during pregnancy, as well as high maternal blood pressure at follow‐up 7–12 years after pregnancy, on blood pressure in children born after normotensive and hypertensive pregnancies.Design. Follow‐up study in children from hypertensive pregnancies and a control group of children born after normotensive pregnancies.Setting. University Hospital, Göteborg, Sweden.Subjects. Thirty‐six children born after hypertensive pregnancies and a control group of 17 children born after normotensive pregnancies were studied at a mean age of 12.5 years.Main outcome measure. Blood pressure.Results. Systolic blood pressure was higher in children born after hypertensive pregnancies. They also had lower birth weight and a shorter gestational period. There was a negative correlation between the highest recorded maternal blood pressure during pregnancy and birth weight of the child and a positive correlation between maternal blood pressure and blood pressure in their offspring. No correlation was found between birth weight and blood pressure in these children.Conclusions. Children born after hypertensive pregnancies have higher blood pressure compared to children born after normotensive pregnancies. There is a positive relationship between childhood blood pressure and maternal blood pressure during pregnancy.
Increased prevalence of insulin‐treated diabetes mellitus in Funen County, Denmark
Authors: ESHØJ O. , GREEN A. , BORCH‐JOHNSEN K. , FELDT‐RASMUSSEN B. , BECK‐NIELSEN H. 
Published: August 2009

Abstract. Objective. To determine the prevalence of insulin‐treated diabetes mellitus in Funen County, Denmark as of 1 July 1987 and compare the findings with those of a similar study from 1973.Design. The population was identified by insulin prescriptions collected during a 1 year period. The identity of the prescription holders, the diagnosis and the date of diagnosis were verified from medical records and public registers.Results. The estimated degree of ascertainment of the material is 0.95–0.97. The prevalence rates (per 1000 of the population) of insulin‐treated diabetes mellitus as of 1 July 1987 are: 4.74 (95% CI 4.66–4.82) for all cases, 2.08 (95% CI 2.01–2.15) for the group with onset of diabetes before age 30 years and 2.66 (95% CI 2.59–2.73) for the group with onset after age 30 years. These figures correspond to increases of 39, 26 and 51% (P < 0.001) on data collected in 1973.Conclusions. There was a significant increase in the prevalence of insulin‐treated diabetes mellitus in Funen County, Denmark from 1973 to 1987. Analysis of the data shows that an important factor for this increase is a liability to start insulin treatment of type 2 (non‐insulin‐dependent) diabetes mellitus at an earlier stage than previously. Also, the data suggest that improved prognosis for diabetic patients as well as an increasing incidence of diabetes mellitus are factors involved in the increase.
Age‐dependent influence of heart rate on Doppler indexes of left ventricular filling
Authors: VOUTILAINENM S. , KUPARI M. , HIPPELÄINEN M. , KARPPINEN K. , VENTILÄ M. 
Published: August 2009

Abstract. Background and objective. The Doppler indexes of left ventricular filling are related to age and heart rate. The aim of this study was to assess whether the influences of heart rate and age interactions (that is, whether the effect of heart rate on the Doppler indexes) is modified by age.Subjects and methods. The effects of atropine‐induced heart rate increases on the transmitral velocities were compared in 10 younger healthy subjects aged 26–38 years and 12 older healthy subjects aged 50–67 years.Results. With a comparable total rise in heart rate (on average 20 beats min‐1), the peak early diastolic velocity decreased likewise in both groups (from 66±9 to 57±9 cm s‐1 in the younger age group and from 58 ± 15 to 47±13 cm s‐1 in the older age group). The peak atrial velocity remained unaltered in the older group (53 ± 16 vs. 52 ± 14 cm s‐1) but rose from 33 ± 6 to 44 ± 12 cm s‐1 in the younger (P = 0.02). The early‐to‐atrial peak velocity ratio decreased from 1.2 ± 0.6 to 1.0 ± 0.4 cm s‐1 in the older subjects and from 2.0 ± 0.5 to 1.4 ± 0.5 cm s‐1 in the younger subjects (P = 0.01). Changes in the other Doppler indexes were similar in both groups.Conclusions. The effect of heart rate on certain Doppler indexes of left ventricular filling is age‐dependent. The peak velocity ratio cannot be interpreted without adjusting for heart rate in younger subjects, whilst in older people heart rate variation is of less importance.
Diagnostic potential of chest pain characteristics in coronary care
Authors: ERIKSSON B. , VUORISALO D. , SYLVÉN C 
Published: August 2009

Abstract. Objectives. To characterize and quantitate the experience of presenting chest pain in coronary care patients in terms of intensity, quality, localization and extension of pain.Design. Localization of presenting chest pain at a body figure and estimation of intensity according to the Borg CR‐10 scale of five qualities related to pain: (i) aching, (ii) burning, pricking, (iii) pressing, throbbing, (iv) dyspnoea, suffocation and (v) anxiety were done within 24 h from onset of symptoms.Setting. Coronary care unit (CCU).Subjects. Eighty consecutive patients of which 40 suffered from acute myocardial infarction (AMI).Results. The AMI and non‐AMI groups did not differ with regard to (i) the intensity of chest pain being mainly of moderate degree and (ii) the mean number of qualities of the presenting chest pain that were between 3 and 4. Patients with AMI reported extension of chest pain over a wider body area than patients in the non‐AMI group (P < 0.0001). A second type of chest pain in addition to the major type of chest pain was reported by only 25% of the patients with AMI compared to 68% in the non‐AMI group (P < 0.0001).Conclusions. Intensity, quality and localization of presenting acute chest pain in patients admitted to the CCU do not differentiate between patients with or without AMI. Extension of pain over a major part of the chest‐related body surface and the absence of secondary pain appear to identify at least half of the patients with ongoing AMI.
Malnutrition and gastrointestinal dysfunction as prognostic factors for survival in familial amyloidotic polyneuropathy
Authors: SUHR O. , DANIELSSON Å. , HOLMGREN G. , STEEN L. 
Published: August 2009

Abstract. Objectives. To describe the evolution of nutritional and neurological complications in a Swedish population of patients with familial amyloidotic polyneuropathy, and to identify prognostic factors and useful tests for monitoring the progress of the disease.Design. Prospective and retrospective study of patients with familial amyloidotic polyneuropathy.Setting. Tertiary referral centre.Subjects. Twenty‐seven patients with familial amyloidotic polyneuropathy, and a symptomatic onset before the age of 50.Main outcome measures. Age at onset, duration of disease before death, serum albumin, body mass index (BMI), duration and grade of peripheral neuropathy and gastrointestinal disturbances. Faecal fat, xylose test and 75selenohomocholic acid‐taurine (SeHCAT) test were used for assessment of malabsorption.Results. Thirteen patients died during the study period after a disease duration of between 9 and 18 years (mean 13). A short time interval between the onset of neurological and of gastrointestinal symptoms had greater impact on survival than age at onset in this selected group of patients (r = 0.65; P = 0.017). Malnutrition was evaluated by multiplying the [body weight (kg)/height2 (m)] with the serum albumin to compensate for oedema. This modified body mass index (mBMI) was significantly correlated to the number of years before death (r = 0.89; P < 0.0005) and to the duration of gastrointestinal symptoms (r = —0.66; P < 0.0005), but not to duration of disease (r = —0.2; P = 0.20). Polyneuropathy was graded according to functional capacity from I to IV (PND score) and was correlated to the number of years before death and mBMI, but not to serum albumin. The SeHCAT test for bile acid malabsorption was significantly correlated to the duration of gastrointestinal symptoms and to mBMI (r = —0.67; P = 0.0003 and r = —0.62; P = 0.003, respectively).Conclusion. The investigation disclosed that a short time interval between the onset of neurological and of gastrointestinal symptoms is associated with a decreased survival time. The mBMI was closely related to time before death, duration of gastrointestinal disturbances, malabsorption and functional capacity. The mBMI appears to be well suited to monitoring disease progress and gives prognostic information.