bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adverse effects of psychosocial stress on gonadal function and insulin levels in middle‐aged males
Authors: NILSSON PETER M. , MØLLER LARS , SOLSTAD KIM 
Published: August 2009

Abstract.Objectives.To investigate the relationship between gonadal function, insulin and psychosocial stress in middle‐aged men.Design.A population‐based, cross‐sectional, observational study.Setting.Glostrup Hospital, Copenhagen, Denmark.Subjects.Four hundred and thirty‐nine males, all aged 51 years.Main variables.Body‐mass index (BMI), waist‐to‐hip ratio (WHR), insulin, C‐peptide, free testosterone, luteinizing hormone (LH), lipids, fibrinogen, lung function tests (FVC, FEV1, PEF), blood pressure; a self‐administered questionnaire with questions on psychosocial variables, lifestyle and self‐rated health.Results.Free testosterone correlated inversely (P< 0.05) with weight, BMI, WHR, and fibrinogen, and positively withFEV1. An independent correlation between free testosterone and insulin (P≤ 0.03), but not with C‐peptide, was seen after controlling for BMI and WHR. Subjects with low levels of free testosterone, or those in the lowest quintile of the distribution of the hypogonadal index (HI: free testosterone/LH), showed a cluster of negative psychosocial variables, and psychological as well as health‐related problems. Furthermore, hypogonadal men had lower (P< 0.05) levels ofFEV1, peak flow andFVC, but higher (P< 0.01) levels of fibrinogen and higher pulse pressure than men with normal gonadal function. This gradient of variables, relative to HI, was not seen for possible confounders like BMI, WHR, and tobacco or alcohol consumption.Conclusion.Psychosocial stress may be associated with a process of premature ageing in middle‐aged males, corresponding to a hypogonadal state as well as to indirect signs of increased insulin resistance.
Cold exposure increases cyclic guanosine monophosphate in healthy women but not in women with Raynaud's phenomenon
Authors: LEPPERT J. , RINGQVIST Å. , AHLNER J. , MYRDAL U. , SÖRENSEN S. , RINGQVIST I. 
Published: August 2009

Abstract. Objective. To investigate influence of whole‐body cooling on cyclic GMP (cGMP) in women with Raynaud's phenomenon and in healthy women.Design. The study was performed as an open, parallel‐group comparison between women with Raynaud's phenomenon and healthy women during the winter month of February.Setting. The municipality of Västerås (Sweden).Participants. The Raynaud group comprised 24 female patients. The control group consisted of 21 healthy females.Main outcome measure. The venous levels of cGMP were measured on three different occasions: just before and after 40 min of whole‐body cooling and after 20 min rest at room temperature (21°C).Results. Venous cGMP increased significantly in the control group after cold exposure (mean difference 0.43 pmol ml−1; 95% CI, 0.018–0.848; t = 2.18; df = 20; P = 0.02) and remained at a high level after 20 min rest (mean difference 0.58 pmol mL−1; 95% CI, 0.063–1.108; t = 2.34; df = 20; P = 0.015). In contrast, the levels of venous cGMP in the Raynaud group did not change significantly. The difference in increase between the two groups was significant (P < 0.02). The diastolic blood pressure in the Raynaud group increased after 40 min of whole‐body cooling and was still significantly increased (P < 0.001) after 20 min rest at room temperature (21 °C).Conclusion. These results indicate that women suffering from Raynaud's phenomenon lack the physiological response of cGMP to cold exposure, which may explain their increased vasospastic response.
Chronic fatigue syndrome: a clinical and laboratory study with a well matched control group
Authors: SWANINK CAROLINE M. A. , VERCOULEN JAN H. M. M. , BLEIJENBERG GIJS , FENNIS JAN F. M. , GALAMA JOEP M. D. , VAN DER MEER JOS W. M. 
Published: August 2009

Abstract. Objective. To investigate the relation between severity of complaints, laboratory data and psychological parameters in patients with chronic fatigue syndrome (CFS).Subjects. Eighty‐eight patients with CFS and 77 healthy controls matched for age, sex and geographical area.Methods. Patients and controls visited our outpatient clinic for a detailed medical history, physical examination and psychological tests: Checklist Individual Strength (CIS), Beck Depression Inventory (BDI) and Sickness Impact Profile (SIP). Venous blood was drawn for a complete blood cell count, serum chemistry panel, C‐reactive protein and serological tests on a panel of infectious agents.Results. All patients fulfilled the criteria for CFS as described by Sharpe et al. (J R Soc Med 1991; 84: 118–21), only 18 patients (20.5%) fulfilled the CDC criteria. The outcome of serum chemistry tests and haematological tests were within the normal range. No significant differences were found in the outcome of serological tests. Compared to controls, significant differences were found in the results on the CIS, the BDI, and the SIP. These results varied with the number of complaints (CDC criteria). When the number of complaints was included as the covariate in the analysis, there were no significant differences on fatigue severity, depression, and functional impairment between patients who fulfilled the CDC criteria and patients who did not.Conclusion. It is concluded that the psychological parameters of fatigue severity, depression and functional impairment are related to the clinical severity of the illness. Because the extensive panel of laboratory tests applied in this study did not discriminate between patients and controls, it was not possible to investigate a possible relation between the outcomes of psychological and laboratory testing.
von Willebrand factor, a possible indicator of endothelial cell damage, decreases during long‐term compliance with a lipid‐lowering diet
Authors: BLANN A. D. , JACKSON P. , BATH P. M. W. , WATTS G. F. 
Published: August 2009

Abstract. Objectives. To test whether serum von Willebrand factor (vWf) would be lower in men with atherosclerosis who had been consuming a lipid‐lowering diet for 3 years than in a control group of men with atherosclerosis who had been following their normal diet.Design. A randomized, population‐based case‐control study.Setting. A tertiary health care referral centre at a University Hospital.Subjects. Men age less than 66 years with angiographically proven coronary atherosclerosis and a cholesterol level > 6 mmol L−1. Sixty started the study and 50 completed it.Interventions. Subjects were randomized to a lipid‐lowering diet or to taking their normal diet for approximately 3 years.Main outcome measures. The components of the subjects' diets were assessed and blood was obtained for total, low‐density lipoprotein (LDL) and high‐density lipoprotein (HDL) cholesterol, triglycerides and for vWf.Results. Men on the lipid‐lowering diet consumed less total, saturated and monounsaturated fats (all P < 0.001), cholesterol and retinol (both P < 0.002) but increased polyunsaturated fats (P < 0.001), fibre, vitamin E (both P < 0.005) and carbohydrate (P < 0.05). Those on the lipid‐lowering diet also had lower serum levels of total and LDL cholesterol (P < 0.002 and P < 0.05, respectively), triglycerides (P < 0.02) and vWf (P < 0.05) than the men on their normal diet. There was no difference in HDL cholesterol. Levels of vWf correlated with both total cholesterol (P < 0.005) and inversely with dietary polyunsaturated fats (P < 0.02).Conclusion. von Willebrand factor, a possible indicator of endothelial cell damage, decreases during long‐term compliance with a lipid‐lowering diet.
Liberalized diet in patients with type 1 diabetes
Authors: MÜHLHAUSER I. , BOTT U. , OVERMANN H. , WAGENER W. , BENDER R. , JÖRGENS V. , BERGER M. 
Published: August 2009

Abstract.Objective.To document that strict dietary regimen are not necessary in the context of intensified insulin therapy.Design.German multicentre, prospective cohort study; 6 years follow‐up.Setting.Ambulatory examination using a mobile ambulance.Subjects.A total of 636 type 1 diabetic patients (age 33 ± 7 years, diabetes duration 15 ± 7 years; mean ± SD), who had participated in a structured, 5‐day, in‐patient, group treatment and teaching programme for intensification of insulin therapy and liberalization of the diabetes diet 6 years prior to follow‐up.Main outcome measures.Relations between the extent to which patients practise a liberalized diet, the degree of metabolic control (HbA1c, severe hypoglycaemia, body mass index, cholesterol), and the patients' perceived burden through dietary treatment.Results.In the total patient group, HbA1c was 7.9 ± 1.6%, and the incidence of severe hypoglycaemia was 0.17 cases per patient during the preceding year; 31% patients injected insulin ≤ 3 times per day, 58% 4–7 times per day, and 11% used insulin pump therapy. Only 11% patients reported following a meal plan, whereas 89% continually changed timing and amount of carbohydrate intake; only 5% had the same number of meals every day, whereas as many as 20% varied the number of meals per day by four or more; 53% skipped main meals; 85% habitually consumed sugar or sugar containing foods. Patients with a higher degree of diet liberalization injected insulin or used an insulin pump therapy more frequently, and perceived their dietary treatment to be less burdensome. No clinically significant associations were found between the extent of diet liberalization and metabolic control.Conclusions.Under the conditions where type 1 diabetic patients have the opportunity to participate in an intensified insulin treatment and teaching programme, liberalization of the diabetes diet is not associated with adverse effects on glycaemic control, but is associated with less perceived burden through dietary treatment.
Structural cardiac changes in relation to 24‐h ambulatory blood pressure levels in borderline hypertension
Authors: LEMNE C. , LINDVALL K. , GEORGIADES A. , FREDRIKSON M. , de FAIRE U. 
Published: August 2009

Abstract. Objectives. To investigate left ventricular hypertrophy (LVH) in relation to 24‐h ambulatory blood pressure (24‐ABPM) and insulin levels in borderline hypertension.Design. A case‐control study.Subjects. Borderline hypertensive men (diastolic blood pressure (DBP) 85–94 mmHg, n = 69) and age‐matched normotensive controls (DBP ≤ 80 mmHg. n = 69) from a population screening programme.Main outcome measures. Echocardiography (M‐mode). insulin (RIA) and 24‐APBM (Del Mar P‐IV) levels.Results. The borderline group showed a significant increase in septal thickness (10.4±1.5 vs. 9.7±1.5 mm. P < 0.01), peak systolic wall stress (218±38 vs. 202±38 103 dynes cm−2, P < 0.05) and a decrease in LV ejection time (28.4±2.5 vs. 29.5±2.1s, P < 0.01). The septum vs. posterior wall thickness ratio was significantly higher in the borderline group (1.13±0.14 vs. 1.06±0.14, P < 0.01). Casual BP levels did not correlate with LVH indices, while 24‐ABPM systolic levels correlated strongly with LVH indices in the borderline group (r = 0.22–0.52, P < 0.05) but not in the normotensive group. Insulin levels correlates strongly with LVH indices in the normotensive group (r = 0.34–0.47, P < 0.01) but not the borderline, group.Conclusions. Signs of asymmetric LVH and altered ventricular function are already detectable in borderline hypertension. The data also suggest that early structural cardiac changes are related to ambulatory blood pressure profile, but not to casual blood pressure or trophic factors such as insulin.
Primary haemostasis in thyroid disease
Authors: MYRUP B. , BREGENGÅRD C. , FABER J. 
Published: August 2009

Abstract. Objectives. There have been reports on a bleeding tendency in hypothyroidism resembling von Willebrand's disease. The aim of the present study was to investigate whether altered primary haemostasis is a general phenomenon in thyroid disease.Design/setting. A total of 10 patients with hyperthyroidism and nine patients with hypothyroidism were studied at diagnosis, and during treatment with carbimazole or L‐thyroxine. respectively, when euthyroidism had been achieved.Results. In untreated hypothyroidism, template bleeding time was prolonged (median 9.3 min, range 3.8–20.0 min) compared to that in controls (median 4.0 min, range 3.0–6.0 min; P < 0.05). whereas maximal agglutination velocity induced by ristocetin was decreased (38% min−1, range 4–52% min−1 vs. 70% min−1, range 60–81% min−1, P < 0.05). The level of von Willebrand factor antigen in plasma from hypothyroid patients was less than half of the value in hyperthyroid patients. This difference disappeared after euthyroidism was achieved.Conclusions. We found that changed primary haemostasis is a general feature of hypothyroidism, and that it is resolved after levothyroxine treatment.
Sleep and hypnotics among the elderly in relation to body weight and somatic disease
Authors: ASPLUND R. 
Published: August 2009

Abstract. Objectives. To investigate the interrelationship between sleep complaints and hypnotics in relation to general health and somatic diseases.Design. An epidemiological survey conducted by means of a questionnaire.Setting. The counties of Västerbotten and Norrbotten in northern Sweden.Subjects. All 10216 members of the Swedish Pensioners' Association.Main outcome measures. Sleep disturbances, health, somatic diseases and hypnotic medication.Results. General ill health, cardiovascular diseases, different painful diseases and increased nocturnal voiding frequency were all associated with poor sleep and increased treatment with hypnotics. Hypnotics were used by 13.5% of the men and 22.3% of the women. Of the men aged < 70 years, 7.9% were receiving such treatment, of those aged 70–80 years 14.4% were using hypnotics, and of those aged ≥ 80 years 21.8% were taking hypnotics (P < 0.0001). The corresponding frequencies among women were 15.0%, 23.0% and 34.9%, respectively (P < 0.0001). Half of all men and women treated with hypnotics in all age groups reported a good night's sleep. Among these both angina pectoris and cardiac arrhythmia were twice as common as among elderly subjects who experienced poor sleep and were receiving treatment with hypnotics.Conclusions. Poor health and different somatic diseases are over‐represented in elderly persons treated with hypnotics.
Hypertension in cyclosporin A‐treated patients is independent of circulating endothelin levels
Authors: FORSLUND T. , HANNONEN P. , REITAMO S. , FYHRQUIST F. 
Published: August 2009

Abstract. Objectives. To measure blood pressure (BP), plasma endothelin‐1 (ET‐1), atrial natriuretic peptide (ANP), antidiuretic hormone (ADH) and aldosterone (ALDO) concentration, and plasma renin activity (PRA) in patients treated with a low‐dose cyclosporin A (CyA).Design. An open study of patients with rheumatoid arthritis (RA) or palmoplantar pustulosis (PPP).Setting. Out‐patient clinics at the Central Hospital of Jyväskylä and Helsinki University Central Hospital.Subjects. CyA was given to 25 patients with RA and to 10 patients with PPP.Intervention. RA patients were given CyA at a dose of 2.5±0.13 mg kg−1 body weight (BW) to 3.47±0.79 mg kg−1 BW (mean values±SD) at the start of the study and after 6 months, respectively, and the CyA dose was 2.67±0.13 mg kg−1 BW decreasing to 2.07±0.96 mg kg−1 (P < 0.001) after 4 months in PPP subjects.Results. Systolic (sBP) and diastolic blood pressure (dBP) increased from 127.8±13.6/79.7±8.4 mmHg to 140.0±19.8/83.8±9.7 mmHg during the study (P < 0.03). Plasma ET‐1, ANP, ALDO and ADH concentration and PRA did not change during 4 to 6 months of CyA treatment. The plasma ANP concentration was constantly higher in CyA‐treated RA patients (112±87 ng l−1) to 118±78 ng l−1) than in PPP patients (37.3±26 ng l−1 to 47.7±39.9 ng l−1; P < 0.02). The serum creatinine concentration remained within the normal range, but increased from baseline (76.7±11.9 μmol l−1), to 90±15.4 μmol l−1 (P < 0.001). The serum magnesium concentration decreased significantly (P < 0.005) after 6 months of CyA treatment in RA patients. No correlation was found between serum creatinine and plasma ET‐1 concentration.Conclusions. Increased blood pressure during CyA treatment was independent of circulating ET‐1 levels. A low dose of CyA did not induce increased ET‐1 synthesis as judged from plasma samples. The high plasma ANP level observed in RA patients could be due to fluid retention caused by concomitant treatment with non‐steroid anti‐inflammatory drugs. Fluid retention and decreased magnesium levels could also be involved in the development of hypertension in CyA‐treated subjects.
Endotoxaemia and inflammatory mediators in febrile patients with haematological disease
Authors: GÜNTHER G. , GÅRDLUND B. , HAST R. , KIMBY E. , NORDIN M. , WRETLIND B. 
Published: August 2009

Abstract. Objectives. To study the pattern of plasma levels of endotoxin, tumour necrosis factor alpha (TNF‐α), interleukin 6 (IL‐6) and C‐reactive protein (CRP) in febrile neutropenic patients and to assess the potential diagnostic value of these analyses.Design. Consecutive prospective study.Setting. Patients treated at the haematology ward at Danderyd Hospital, Sweden.Subjects. Ninety‐four patients with fever and haematological disease entered the study (male/female: 59/35) with 176 febrile episodes.Interventions. Blood samples were drawn at days 0, 1, 2 and 6 after onset of fever for analysis of, endotoxin, TNF‐α, IL‐6 and CRP.Results. Infectious aetiology was established in 62.5% of the febrile episodes. Blood cultures showed significant growth in 71/176 (40.3%) febrile episodes. Nonbacteraemic bacterial infections were diagnosed in 34/176 (19.3%) episodes. Endotoxin was detected in plasma in 40% of febrile episodes regardless of aetiology. TNF‐α was detected in 61% and IL‐6 in 94% of all febrile episodes. The initial TNF‐α and IL‐6 levels were significantly higher in patients with Gram‐negative bacteraemia than in patients with other causes of fever (P < 0.001). In episodes evaluated as successful after empirical antibiotic treatment, a significant (P < 0.001) decrease in CRP concentrations were found on day 6 after onset of fever.Conclusions. The sustained, low‐grade endotoxaemia and persistently elevated levels of TNF‐α and IL‐6 found in febrile patients may reflect a failing mucosal barrier that allows endogenous bacterial products to reach the circulation. The diagnostic value of endotoxin, TNF‐α, IL‐6 and CRP to discriminate between bacteraemic and nonbacteraemic febrile episodes was very limited. The study supports the present policy of broad, empirical antibiotic treatment in patients with haematological disease and fever.
High serum alpha‐tocopherol, albumin, selenium and cholesterol, and low mortality from coronary heart disease in northern Finland*
Authors: LUOMA P. V. , NÄYHÄ S. , SIKKILÄ K. , HASSI J. 
Published: August 2009

Abstract. Objectives. The mortality from coronary heart disease (CHD) is exceptionally low in northernmost Finland, the Sámi (formerly known as Lapp) area. To clarify the reasons for this, the levels of serum cholesterol, other classic risk factors, and major antioxidants, alpha‐tocopherol, retinol, albumin and selenium were determined in males living in the low‐mortality area and in a reference area.Design. A health survey amongst reindeer herdsmen living in the three northernmost communes of Finland (the Sámi area) and in the six neighbouring communities to the south (the reference area). The mortality from CHD in the two areas was determined from death certificates issued during the period 1981–1990.Subjects. A total of 350 participants of the health survey, mean age 46 (SD 14) years.Results. The mortality from CHD was 17% lower in the Sámi area than in the reference area [95% confidence interval (CI) for the difference: 4–29]. Subjects living in the low‐mortality area showed higher serum‐lipid‐adjusted alpha‐tocopherol (18.4 vs. 16.1 μmol L−1; 95% CI for difference: 0.7–3.9; P < 0.001), albumin (46.9 vs. 46.2 g L−1; 0.2–1.3; P < 0.02), selenium (1.59 vs. 1.47 μmol L−1; 0.02–0.22; P < 0.02), cholesterol (6.76 vs. 6.34 mmol L−1; 0.12–0.72; P < 0.001) and LDL cholesterol (4.76 vs. 4.45 mmol L−1; 0.05–0.57; P < 0.02) than those in the reference area. The HDL cholesterol: cholesterol ratio was lower in the Sámi area than in the reference area (0.20 vs. 0.21; –0.02–0.00; P < 0.04). The Sámis showed higher serum selenium than the Finns, Serum alpha‐tocopherol increased with the consumption of reindeer meat and serum selenium increased with fish consumption.Conclusions. Alpha‐tocopherol, albumin and selenium may play a role in the low mortality from CHD observed in northernmost Finland. The favourable serum antioxidant status in northerners may be credited to the local diet.
Coffee consumption and risk of ischaemic heart disease — a settled issue?
Authors: GYNTELBERG F. , HEIN H. O. , SUADICANI P. , SØRENSEN H. 
Published: August 2009

Abstract. Objective. Based on a meta‐analysis, it was recently stated that there is no association between coffee consumption and the risk of coronary heart disease. Why then, have studies on the issue shown quite variable results?Design, setting and subjects. A prospective study was performed in the Copenhagen Male Study on 2975 men (53–74 years) without cardiovascular disease at the baseline in 1985/1986. They were classified according to self‐reported consumption of filter coffee. Some 147 men (5%) were coffee abstainers. Potential confounders were alcohol use, physical activity, smoking, serum cotinine, serum lipids, serum selenium, body mass index, blood pressure, Lewis blood group, hypertension, non‐insulin‐dependent diabetes mellitus and social class.Main outcome measures. The incidence of ischaemic heart disease (IHD) 1985/86–1991.Results. Some 184 men had a first IHD event. There was no significant difference between those consuming 1–4, 5–8 or ≥ 9 cups per day after controlling for confounders (P‐value of trend test: 0.14). The crude incidence rates were 6.8, 6.7 and 4.6%, respectively; the adjusted rates were 6.8, 6.7 and 4.0%, respectively. Coffee consumption was significantly (P < 0.05) inversely correlated with serum selenium concentration (never previously described) and, positively or negatively, with a number of other potential risk factors: smoking, alcohol use, serum triglycerides, serum cholesterol, blood pressure, social class, body mass index, and serum selenium. In nonsmokers and smokers of only a small amount of tobacco, coffee consumption was associated with a lower risk of IHD (P < 0.05).Conclusion. We conclude that the association between coffee consumption and risk of IHD is conditioned by known risk factors correlated with use of coffee, which may partly explain the inconsistencies in the results of previous studies.