bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sleep habits and sleep disturbances among the elderly—an epidemiological survey
Authors: GISLASON T. , REYNISDÓTTIR H. , KRISTBJARNARSON H. , BENEDIKTSDÓTTIR B. 
Published: August 2009

Abstract. Objectives. To analyse simultaneously sleep habits and sleep disturbances in an elderly population and numerous factors possibly affecting sleep at the same time.Design. A cross‐sectional epidemiological survey by means of questionnaires.Setting. The capital city of Iceland, Reykjavik and surrounding suburbs.Participants. A randomly selected, but stratified sample with 100 men and 100 women in each 5‐year age group of the ages 65–84 years—800 individuals altogether.Main outcome measure. Sleep habits and sleep disturbances.Results. The mean duration of sleep was 7.25 h (sd 74 min). Mean sleep onset time was 00.13 hours and was not related to age and gender but was delayed at weekends. Daytime napping was reported by 50% of the men and 31% of the women (P < 0.001). Difficulty maintaining sleep (DMS) was the most commonly reported insomnia complaint (men 37% and women 30%). Sleep charts revealed that men woke up an average of 1.2 times per night but women 0.8 times per night (P < 0.01). Difficulty initiating sleep was reported by 9.6% and early morning awakening (EMA) by 16.7%. Pain was a strong factor contributing to EMA. There was also an increase in EMA complaints among the elderly with obstructive pulmonary diseases and systemic hypertension. The prevelance of insomnia was only partly related to age and gender. Multiple regression analyses, however, showed different interrelationships between insomnia and other symptoms and findings for men versus women.Conclusion. DMS is the most commonly reported insomnia complaint among the elderly (men 37% and women 30,%). The prevalence of insomnia did not increase with age in our study group.
Anaphylatoxins in dilated cardiomyopathy
Authors: SAMSONOV M. , NASSONOV E. , MASENKO V. , NAUMOV V. , MAREEV V. , BELENKOV Yu. 
Published: August 2009

Abstract. Objects. The aim of the study was to investigate the possible relationship between activation of complement system and thromboembolic complications in dilated cardiomyopathy (DCMP).Methods. The plasma C3a and C5a concentrations were determined by radioimmunoassay measurement (Amersham International, UK) in 23 patients with DCMP, 9 with hypertrophic cardiomyopathy (HCMP) and 11 healthy volunteers.Results. The mean C3a concentration was significantly higher in DCMP patients (572 ± 55 ng ml−1) compared with hypertrophic cardiomyopathy (344 ± 30 ng ml−1) and with healthy controls (294 ± 43 ng ml−1) (P < 0.001). There were no significant correlations for C5a concentrations in this group. Mean C3a concentration in DCMP patients with thromboembolic complications (736 ± 95 ng ml−1) was also significantly higher compared with DCMP patients without these complications (344 ± 14 ng ml−1) (P < 0.001).Conclusions. We conclude that anaphylatoxins may play a role in the pathogenesis of thromboembolic complications.
No evidence of mitochondrial abnormality in skeletal muscle of patients with iron‐deficient anaemia
Authors: THOMPSON C. H. , KEMP G. J. , TAYLOR D. J. , RADDA G. K. , RAJAGOPALAN B. 
Published: August 2009

Abstract. Objectives. Patients with iron deficiency anaemia complain of decreased exercise capacity. We asked whether this is due to defective oxidative ATP synthesis in skeletal muscle as a consequence of reduced blood oxygen content and/or intrinsic mitochondrial abnormalities.Design. We used 31P magnetic resonance spectroscopy to examine skeletal muscle bioenergetics in iron‐deficient patients and in age‐ and sex‐matched controls.Setting. The patients were recruited from the primary care population.Subjects. We studied seven symptomatic female iron‐deficient patients (aged 32–70 years) with haemoglobin (Hb) concentration, [Hb], 8.0 g dl−1. Six had menorrhagia, the cause in the seventh patient remained undiagnosed. Results were compared with those of 8 healthy female controls (aged 25–48 years) with mean [Hb] 13.7 g dl−1.Results. The right calf muscle was by studied 31P magnetic resonance spectroscopy in a 1.9 T superconducting magnet. We measured the intracellular concentrations of phosphocreatine (PCr), inorganic phosphate (Pi), adenosine triphosphate (ATP) and the intracellular pH at rest, during plantar flexion exercise and during recovery from exercise.Exercise duration was reduced in the patients, yet end‐exercise PCr/(PCr + Pi) was higher and adenosine diphosphate (ADP) lower than in controls. After exercise, initial PCr recovery was slowed but this was probably because of the lower cytosolic ADP concentration.Conclusions. Mitochondrial ATP synthesis was not limited by oxygen supply or an intrinsic mitochondrial defect. Therefore, the reduced exercise capacity seen in iron deficiency could be due to central causes and not to skeletal muscle metabolic abnormalities.
Accuracy of clinical diagnoses in a teaching hospital: a review of 997 autopsies
Authors: KAJIWARA J. K. , ZUCOLOTO S. , MANÇO A. R. X. , MUCCILLO G. , BARBIERI M. A. 
Published: August 2009

Abstract. Objectives. To analyse the concordance between clinical and autopsy diagnoses.Design. Nine‐hundred‐and‐ninety‐seven autopsies were studied comparing the diagnoses of the autopsy requests with those of the death certificates and autopsy reports. The cases were grouped according to the 17 categories of diseases of the International Classification of Diseases (ICD) and the concordance was analysed with the k (kappa) coefficient of concordance.Setting. The Hospital da Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRPUSP), Ribeirão Preto, SP, Brazil.Subjects. The patients autopsied at HCFMRPUSP during the period between 1978 and 1980.Main outcome measures. k statistics offer an alternative approach to measuring the concordance between clinical and autopsy diagnoses.Results. The k‐value obtained was equal to 0.601 with a variance of 1.545 times 10−4 when comparing the clinical diagnoses and the autopsy diagnoses, and equal to 0.661 with a variance of 1.531 times 10−4 comparing the clinical diagnoses with those obtained after the gross examination. These values are significant at the level of 5%, i.e. there is an overall statistical concordance between clinical and autopsy diagnoses although the value is not absolute (k= 1.00).Conclusions. If autopsies are heeded without bias, they will continue to give important feedback concerning medical diagnosis.
Hand abnormalities are strongly associated with the duration of diabetes mellitus
Authors: GAMSTEDT A. , HOLM‐GLAD J. , OHLSON C.‐G. , SUNDSTRÖM M. 
Published: August 2009

Abstract. Objectives. To study the prevalence of hand abnormalities in diabetic patients and to evaluate associations between the hand abnormalities and diabetic variables, ergonomic factors and smoking habits.Design. Cross‐sectional study of 100 patients selected at random.Setting. Out‐patient clinic, Department of Internal Medicine, Örebro Medical Centre Hospital in Sweden.Main outcome measures. Presence and extent of carpal tunnel syndrome (CTS), Dupuytren's contracture (DC), flexor tenosynovitis (FTS), and limited joint mobility (LJM). Duration of diabetes, metabolic control, chronic diabetic complications, blood pressure, ergonomic factors and smoking habits.Results. Carpal tunnel syndrome, DC, FTS and LJM were each present in about 20% of the patients. Hand abnormalities were observed in 50 patients and more than one abnormality was found in 26 of the patients. The hand abnormalities were associated with the duration of diabetes but not with the metabolic control or with other diabetic complications. However, the diabetic complications were associated with bad metabolic control and with the duration of diabetes. Hand abnormalities correlated with heavy manual work but not with smoking habits. Twenty‐five of the 50 patients with hand syndromes were disabled to such an extent that surgery was recommended.Conclusion. The prevalence of hand abnormalities in diabetic patients is high and increases with the duration of diabetes. In many cases patients with hand abnormalities can be helped by surgery.
Correspondence between screening and intra‐arterial blood pressures in young men with borderline hypertension
Authors: BERGBRANT A. , HANSSON L. , JERN S. 
Published: August 2009

Abstract. Objectives. To evaluate the screening blood pressure (BP) for identification of individuals with a mild but persistent elevation of BP refered to as borderline hypertension (BH).Design. Based on screening data from approximately 10500 men at a military enlistment centre in 1987; an unbiased population sample of young men were recruited. Blood pressure follow‐up and investigation of anthropometric and metabolic data were made at Östra Hospital.Subjects. Men aged 19.8 years (range 17–28) were screened. Three hundred and six were found to have elevated BP (systolic BP (SBP) > 145 mmHg and/or diastolic BP (DBP) ≥ 85 mmHg). Of these, 179 were re‐examined after 1–3 years, by which time three individuals exceeded the limits for established hypertension and 80 fulfilled the BP criteria for BH (in two out of two blood pressure measurements). Fifty‐four of these BH individuals were investigated with intra‐arterial (i.a.) BP measurements. A normotensive control (NC) group (SBP 110–130 and DBP 60–80 mmHg; n = 20) from the same population was examined concomitantly.Results. At screening, at the 2‐year clinic follow‐up and again during the intra‐arterial recording, SBP was significantly different in BH vs. NC. With DBP an increasing difference between the groups was observed with time. There were highly significant correlations between screening and 2‐year clinic BP (r = 0.72, P < 0.001; n = 74) and screening and i.a. BP (r = 0.57, P < 0.001; n = 74).Conclusions. These data show that there is a correspondence between BP at the screening procedure and i.a. BP measured 2 years later, indicating that the screening procedure is a useful way of identifying young men with mild but persistent BP elevation. This interpretation is supported by metabolic and biochemical differences between the groups.
Cardiovascular risk factors in treated hypertensives—a nation‐wide, cross‐sectional study in Sweden
Authors: NILSSON P. , ANDERSSON D. K. G. , ANDERSSON P.‐E. , SCHWAN Å , ÖSTLIND B. , MALMBORG R. , LITHELL H. , ANDERSSON O. K. 
Published: August 2009

Abstract. Hypertensive patients still face a considerable risk of cardiovascular disease in spite of drug treatment in many studies. This may partly be explained by metabolic disturbances, both primarily linked to hypertension but also secondarily influenced by anti‐hypertensive drugs themselves.In order to evaluate residual cardiovascular risk factors we investigated 1915 treated hypertensives (912 males, 1003 females) attending 128 health centres from all parts of Sweden.Mean blood pressure was 148/91 mmHg for males and 151/90 for females, but a substantial proportion of all patients were not well controlled, having a diastolic blood pressures ≥ 100 mmHg (17% males, 12% females). Total cholesterol and HDL‐cholesterol were 6.03 and 1.25 mmol l−1 for males, and 6.40 and 1.50 for females. The corresponding figures for serum triglycerides were 2.03 and 1.72 mmol l−1 respectively. In all, 38% of the hypertensives had hypercholesterolaemia (≥ 6.5 mmol l−1) and 27% hypertriglyceridaemia (≥ 2.3 mmol l−1). The lipid/lipoprotein findings may also be influenced by the various anti‐hypertensive drugs used in Sweden. The prevalence of smoking and diabetes mellitus were 25% and 11% for men, and for women 24% and 9%.In conclusion, Swedish hypertensives show evidence of significant residual cardiovascular risk factors in spite of treatment. This may be of importance for future relative and absolute cardiovascular risk. It is time to re‐evaluate the effectiveness of our management and care of hypertensive patients.
Benefits and liabilities of hypermobility in the back pain disorders of industrial workers
Authors: LARSSON L.‐G. , Mudholkar Govind S. , BAUM J. , SRIVASTAVA D. K. 
Published: August 2009

Abstract. Objectives. Back pain disorders, sometimes called ‘the nemesis of medicine and the albatross of industry’, are ubiquitous, but have stubbornly defied diagnosis and treatment. Hypermobility syndrome, which is also very common, has been called ‘an enigma of human physiology’. Both conditions have attracted wide attention and interest only recently. In an earlier study, we considered the benefits and liabilities of joint hypermobility by studying 660 musicians in the USA. In a parallel manner, the present study analysed the back pain disorders of 606 workers in a Swedish high‐technology industrial plant in the context of spinal hypermobility.Subjects and methods. The 606 industrial workers were examined for spinal hypermobility using a standard protocol, and interviewed for work‐related body‐posture requirements and the low back, shoulder and neck pain disorders experienced by them. The data were analysed for associations between hypermobility and physical complaints as a whole, and by taking into account gender and body‐postures at work.Results. Twenty‐six per cent (37) of 144 workers with hypermobility but only 14% (64) of 453 without hypermobility experienced back pain (P < 0.002). Among the 326 workers with sitting or standing jobs, 40% (29) of 71 with hypermobility had back pain, whereas only 12% (30) of the 255 without hypermobility experienced back pain (P < 0.001). The corresponding numbers with back pain for 235 in jobs with changing body‐postures were 4.5% (3) of 66 with hypermobility and 14% (14) of 169 without hypermobility (P = 0.04).Conclusions. Hypermobility of the spine is an asset if the work requires change of body‐posture, but a liability for those in a standing or sitting assignment. It reinforces a similar hypothesis proposed by Larsson et al.
Medical ethics – new horizons
Authors: Böttiger Lars Erik 
Published: August 2009

Abstract. The medical ethics of Hippocrates are no longer sufficient in a society with changing social attitudes and, especially, rapidly developing medical technologies.This Minisymposium is the third in a series of three, dealing with Medical Journals (J Intern Med 1992; 231: 99–102) and their central role in the distribution of new medical knowledge, bringing them into close contact with Scientific misconduct in medical research (J Intern Med 1994; 235: 103–35) and Medical ethics (this Minisymposium). The contents of the three Minisymposia are of importance not only to those dealing with medical journals but to all physicians – regardless of whether they are involved in research or in patient care – and to all others involved in health care.The Minisymposium gives a brief history of the development of research ethics, widens the scope of medical ethics and discusses its transcultural aspects. From a more practical standpoint the two last articles deal with the problem of who makes the decisions for whom, and when to stop treatment – both with relevance to one of the most important problems of medicine today: prioritization.The reader should note the difference between ‘medical ethics’, which is the wider concept, and ‘research ethics’, which deal specifically with the relation between the researcher and her/his patient or volunteer.
Research ethics – a widening of the scope and extrapolation into the future
Authors: RIIS P. 
Published: August 2009

Abstract. Until recently, the concept of research ethics covered only the safety of, and the respect for, the research subject, i.e. the trial patient and the healthy volunteer. The reason was obviously that human research subjects are the most vulnerable of all key persons involved in biomedical research, and the fact that this vulnerability was made tragically visible through the atrocities of World War II.Not in any way to detract importance from this part of research ethics these years experience a widening of the conceptual scope, involving not only the researcher and his or her honesty but also society as a whole, not just duties and rights considered unilaterally but bilaterally. And further, including perspectives as science freedom and a given generation's responsibility for its global fellow‐men and for future generations.
Sex Steroid Levels in XY Males and Sex‐Reversed XX Males, of Rainbow Trout (Oncorhynchus mykiss), During the Reproductive Cycle
Authors: Espinosa E , Josa A , Gil L , González N 
Published: August 2009

ContentsIn this study, the annual cycle of the gonadal steroids testosterone (T), 11‐ketotestosterone (11‐KT), 17β‐oestradiol (E2) and 17α, 20β‐dihydroxy‐4‐pregnen‐3‐one (DHP) was determined using radioimmunoassay and then compared, for XY males (n = 35) and sex‐reversed XX males (n = 27) rainbow trout, to establish possible endocrinology differences. Both in XY males and sex‐reversed XX males, significant correlation was shown between body weight and T (r = 0.5046 and 0.34078, respectively; p < 0.0001) or KT (r = 0.52494 and 0.43545, respectively; p < 0.0001) concentrations. Plasma androgen levels in XY and sex‐reversed XX males were similar and showed an intense seasonal variation. The highest levels for T and 11‐KT were detected from December to April with a peak in January (51.67 ± 5.11 and 61.95 ± 4.25 ng/ml, for XY males and 57.1 ± 5.82 and 59.27 ± 4.84 ng/ml, respectively, for XX males). In addition, there was a positive correlation (p < 0.0001) between T and 11‐KT levels for XY males (r = 0.7533) and sex‐reversed XX males (r = 0.6019). Concentrations of DHP in XY males also showed seasonal variation with a peak in February (25.18 ± 12.99 ng/ml). However, DHP levels in sex‐reversed XX males were undetectable (<0.1 ng/ml) over the year. Levels of E2 were undetectable through the year in both groups of trout. In conclusion, the androgenic and oestrogenic profiles of sex‐reversed XX males were similar to those observed in XY males. The only difference in the annual gonadal steroid cycle between XY and sex‐reversed XX males was in the DHP profile.
Chlorhexidine prevents hypochlorous acid‐induced inactivation of α1‐antitrypsin
Authors: Montecucco F , Bertolotto M , Ottonello L , Pende A , Dapino P , Quercioli A , Mach F , Dallegri F 
Published: August 2009

Summary1. Chlorhexidine digluconate has been used as a topical antiseptic in the treatment of acne vulgaris and periodontitis. The acute phase of these diseases involves neutrophilic infiltration. Neutrophil activation and recruitment to inflammatory sites are crucial in both protection against bacterial infection and the induction of hystotoxic damage. Activated neutrophils release several enzymes, including elastase and myeloperoxidase (MPO), which contribute to tissue injury via direct toxic actions, the generation of oxidants and inactivation of protective factors, such as α1‐antitrypsin (α1‐AT). In the present study, we investigated whether chlorhexidine can modulate neutrophil‐mediated histotoxicity.2. Human primary neutrophils were isolated from healthy donors. Inactivation of α1‐AT by neutrophils or hypochlorous acid (HOCl) was evaluated by spectrophotometry and sodium dodecyl sulphate–polyacrylamide gel electrophoresis analysis of its capacity to complex with porcine pancreatic elastase (PPE). Neutrophil generation of HOCl, superoxide anion and MPO release were assessed spectrophometrically.3. Chlorhexidine (0, 0.5, 1, 5 and 10 μmol/L) dose‐dependently prevented HOCl‐induced inactivation of α1‐AT and reduced HOCl recovery from phorbol myristate acetate (PMA)‐treated human neutrophils, but did not inhibit superoxide anion and MPO release. Chlorhexidine directly inhibited HOCl recovery from neutrophils and HOCl‐induced inactivation of α1‐AT in a cell‐free assay. Accordingly, chlorhexidine reversed HOCl‐mediated inhibition of α1‐AT capacity to complex with PPE.4. These data suggest that chlorhexidine prevents neutrophil‐induced α1‐AT inactivation via a direct inhibitory action on HOCl. Although highly speculative, the present study indicates that chlorhexidine may protect inflamed tissues not only through its antimicrobial properties, but also via a direct anti‐inflammatory effect on neutrophil toxic products.
Reactive oxygen species and insulin‐resistant cardiomyopathy
Authors: Mellor Kimberley M , Ritchie Rebecca H , Delbridge Lea MD 
Published: August 2009

Summary1. The prevalence of insulin resistance has increased markedly in the past decade and is known to be associated with cardiovascular risk. Evidence of an insulin‐resistant cardiomyopathy, independent of pressure or volume loading influences, is now emerging.2. Cardiac oxidative stress is often observed coincident with insulin resistance and there is accumulating evidence that reactive oxygen species (ROS) mediate deleterious effects in the insulin‐resistant heart. It is established that ROS modification of signalling proteins can adversely modulate cellular processes, leading to cardiac growth remodelling and dysfunction. The mechanisms of ROS‐induced damage in insulin‐resistant cardiomyopathy are yet to be fully elucidated.3. A number of different animal models have been used to study cardiac insulin resistance, including high‐sugar dietary interventions, genetically modified diabetic mice and streptozotocin‐induced diabetes. Mechanistic studies manipulating cardiac anti‐oxidant levels, either endogenously or exogenously, in these models have demonstrated a role for ROS in the cardiac manifestations associated with insulin resistance.4. The present review summarizes the cardiac‐specific characteristics of insulin resistance, the features of cardiac metabolism relevant to ROS generation and ROS‐mediated cardiomyocyte damage pathways. In vivo studies in which a combination of genetic and environmental variables have been manipulated are considered. These studies provide particular insights into the induction and suppression of insulin‐resistant cardiomyopathy.
Dissecting the mechanism of Ca2+‐triggered membrane fusion: Probing protein function using thiol reactivity
Authors: Furber Kendra L , Dean Kwin T , Coorssen Jens R 
Published: August 2009

Summary1. Ca2+‐triggered membrane fusion involves the coordinated actions of both lipids and proteins, but the specific mechanisms remain poorly understood. The urchin cortical vesicle model is a stage‐specific native preparation fully enabling the directly coupled functional–molecular analyses necessary to identify critical components of fast triggered membrane fusion.2. Recent work on lipidic components has established a direct role for cholesterol in the fusion mechanism via local contribution of negative curvature to readily enable the formation of transient lipidic fusion intermediates. In addition, cholesterol‐ and sphingomyelin‐enriched domains regulate the efficiency of fusion by focally organizing other components to ensure an optimized response to the triggering Ca2+ transient.3. There is less known about the identity of proteins involved in the Ca2+‐triggering steps of membrane fusion. Thiol reagents can be used as unbiased tools to probe protein functions. Comparisons of several thiol‐reactive reagents have identified different effects on Ca2+ sensitivity and the extent of fusion, suggesting that there are at least two distinct thiol sites that participate in the fusion mechanism: one that regulates the efficiency of Ca2+ sensing/triggering and one that may function during the membrane merger event itself.4. To identify the proteins that regulate Ca2+ sensitivity, the fluorescent thiol reagent Lucifer yellow iodoacetamide was used to potentiate fusion and simultaneously tag the proteins involved. Ongoing work involves the isolation of cholesterol‐enriched membrane fractions to reduce the complexity of the labelled proteome, narrowing the number of candidate proteins.