bluuebunny/crossref_metadata_2025_split huggingface dataset:
Drug related hospital admissions: the role of definitions and intensity of data collection, and the possibility of prevention
Authors: HALLAS J. , HARVALD B. , GRAM L. F. , GRODUM E. , BRØSEN K. , HAGHFELT T. , DAMSBO N. 
Published: August 2009

Abstract. Three hundred and thirty‐three consecutive patients in a medical ward were evaluated in a high‐intensity monitoring scheme for drug events as a cause of hospitalization. Taking into consideration only ‘definite’ and ‘probable’ drug events, we found 36 cases (10.8%) of all admissions to be drug‐related hospitalizations (DRH). Of these, 8.1% were adverse drug reactions and 2.7% were therapeutic failures due to ineffective dosage. In 8 cases (2.4%) the drug event could definitely have been avoided, and a further 13 cases (3.9%) were considered to have been potentially avoidable if appropriate measures had been taken by the health service. In 19 cases (53%) the referring physician was unaware of the drug‐related problem. Those patients admitted because of a drug event were taking significantly more drugs than other individuals. The avoidable drug events pointed to the primary health care physicians as the appropriate targets for preventive measures in terms of intensified drug education.The study demonstrated that a reliable estimate of the DRH rate requires active data collection by a qualified health service worker in close collaboration with the patient's family doctor in cases of suspected DRH.
Serum lipids and lipoprotein in adult Ghanaians
Authors: NYARKO N. K. , ADUBOFOUR K. O. M. , OFEI F. , POBEE J. O. M. , OWUSU S. K. 
Published: August 2009

Abstract. Objectives. To date, no measurement of serum lipid levels in healthy adult Ghanaians have been carried out. This study was undertaken with the objective of providing reference values for serum lipids levels in the Ghanaian population.Design/setting. Fasting serum lipid levels were measured in 79 adult Ghanaians living in an urban setting. Volunteers were randomly selected from the work force of the University of Ghana in Accra. There were 54 males and 25 females in the study population.Results. The mean serum cholesterol (SC) for Ghanaian males was 4.27 ± 1.00 mmol L−1. A value of 4.34 ± 1.12 mmol L−1 was obtained for the females in this study. High‐density lipoprotein cholesterol (HDL‐C) in Ghanaian males averaged 1.37 ± 0.44 mmol L−1 and 1.47 ± 0.50 mmol L−1 in females.There was no statistically significant difference in low‐density‐lipoprotein cholesterol (LDL‐C) and very‐low‐density‐lipoprotein cholesterol (VLDL‐C) levels between the females and males in this study.Conclusions. Compared to other studies, our results show that populations in Europe and North America have higher levels of total cholesterol and LDL cholesterol than Ghanaians. The levels of HDL cholesterol as well as VLDL cholesterol are higher in Ghanaians than in Europeans and Americans. Further work needs to be done to compare lipid levels in urban and rural Ghanaians as well as in those with cardiovascular disorders.
Types of diabetes treatment in a total, Norwegian, adult population: The Nord‐Trøndelag Diabetes Study
Authors: MIDTHJELL K. , HOLMEN J. , BJøRNDAL A. 
Published: August 2009

Abstract. Objectives. To describe types of diabetes treatment in a total, adult population, including those on no antidiabetic medication, and to evaluate use of the defined daily doses in estimation of diabetes prevalence.Design. Cross‐sectional epidemiologic survey applying patient‐based questionnaires and clinical examinations approaching all inhabitants of ≥ 20 years (85 100).Setting. Nord‐Trøndelag county in the middle part of Norway.Subjects. All known diabetic patients in the county (2242) amongst all participants of ≥ 20 years (76855), registered in 1984‐86.Interventions. Questionnaire data on type of diabetes treatment including drug doses, measurement of height and weight.Main outcome measures. Distribution of types of treatment and of mean drug doses.Results. Of the diabetic patients of ≥ 20 years of age, 20% used insulin, 39% oral hypoglycaemic agents and 41% no antidiabetic medication. Corresponding prevalence figures were 0.6%, 1.1% and 1.2%. Mean daily insulin dose per kg body weight was significantly higher in women than in men. Women with no antidiabetic medication stated a more restricted diet than men. The mean prescribed insulin dose was 14% higher than the defined daily dose, but the corresponding oral agent dose was lower than the defined daily dose.Conclusions. Sales figures is a bad estimate of total diabetes prevalence due to the high proportion of diabetic patients using no antidiabetic medication. Correction is also necessary when the defined daily dose system is used to estimate the prevalence of medically treated diabetes.
Metabolic evolution of type 2 diabetes: a 10‐year follow‐up from the time of diagnosis
Authors: NISKANEN L. , KARJALAINEN J. , SIITONEN O. , UUSITUPA M. 
Published: August 2009

Abstract. Objectives. To investigate fasting and post‐load plasma glucose, insulin and C‐peptide levels during oral glucose tolerance tests in patients with type 2 diabetes and in control subjects, and the metabolic evolution of the diabetes.Design, setting and subjects. A 10‐year prospective study consisting of a representative group of 133 (70 men, 63 women) newly diagnosed type 2 diabetic patients diagnosed at health centres between 1979 and 1981 and 144 (62 men, 82 women) nondiabetic control subjects recruited from the population register. At baseline, diabetic subjects were treated with diet only. The subjects were studied at baseline and after 5 and 10 years.Main outcome measures. The changes in plasma glucose, insulin and C‐peptide levels in diabetic and control subjects at baseline and after 5 and 10 years follow‐up. Factors associated with the decline in insulin and C‐peptide levels in diabetic patients (e.g. metabolic control, islet cell antibodies).Results. A slight increase in glucose levels was seen during the follow‐up in both diabetic with diet and/or oral drug treated patients, but post‐glucose insulin (and C‐peptide and 5‐ and 10‐year examination) levels declined in diabetic patients; this was opposite to the controls, in whom the levels tended to increase. The decline in insulin levels (area under the curve) during the follow‐up was greatest in those diabetic patients with poor metabolic control during the follow‐up. The cumulative incidence of requirement for insulin based on various cut‐off levels for post‐glucagon C‐peptide nearly doubled between the 5‐ and 10‐year examinations. Islet cell antibodies were predictive of insulin deficiency.Conclusions. Type 2 diabetes was characterized by progressive impairment of insulin response to glucose and this decline was associated with poor metabolic control of diabetes.
Personality pattern in peptic ulcer disease: a cohort study
Authors: JESS P. 
Published: August 2009

Abstract. Objectives. To investigate the direction of a possible relationship between peptic ulcer disease and personality disorders.Design. A cohort study of 50‐year old patients, observed for 2 decades.Setting. Glostrup County, Denmark (population 100000).Subjects. A representative sample of 50‐year old people born in 1914 (n = 673) were followed for 20 years. All 673 filled in the Minnesota Multiphasic Personality Inventory (MMPI) in 1964 and 513 were retested with MMPI in 1974.Main outcome measures. Prevalence of peptic ulcer disease 1964, incidence of peptic ulcer disease 1964‐84, MMPI scores.Results. The prevalence of peptic ulcer disease in 1964 was 7% and the average annual incidence in the period 1964‐84 was 2.1 per 1000 persons. Those with incidental peptic ulcer in 1964‐84 had normal MMPI scores in 1964, whilst those with peptic ulcer in 1964 had a slight but statistically significant increase in one neuroticism scale (HS) only. The group with prevalent ulcer disease in 1974 exhibited statistically significant increases in the three neuroticism scales (HS, D, HY) and in scale Pd and scale Pt at MMPI retesting. In addition they had statistically significantly higher scores in the three neuroticism scales compared with the other persons who still had normal scores in all scales.Conclusions. Personality disorders in patients with peptic ulcer are consequences of the disease and not causal factors.
Insulin responses to glucose in healthy males are associated with adult height but not with birth weight
Authors: ALVARSSON M. , EFENDIC S. , GRILL V. E. 
Published: August 2009

Abstract. Objective. To investigate the relations between height, birth weight and insulin secretion.Subjects and design. Subjects were selected from a register of all male healthy volunteers who had previously participated in insulin secretion studies. All men in whom a 1‐h glucose infusion test had been performed on two or more occasions were selected (n = 88). Subjects were divided into two equally sized groups according to 0–10‐min insulin responses.Main outcome measures. Insulin responses were measured by standardized glucose infusion tests. Heights and weights were measured on these occasions. Birth weights were obtained from questionnaires and validated from obstetric records.Results. The average height for the 50% of subjects with the lowest insulin response was 3.5 cm less [95% confidence interval (CI): 1.1 to 5.9] than in those with the highest response, P < 0.005. These differences were also significant when expressed relative to heights of national cohorts with the same years of birth [1.7% less in those with lowest response (95% CI: 0.3 to 3.0), P < 0.02 for difference]. However, birth weight (known to 69% of subjects) was not associated with insulin response (3706 ± 126 g in the 50% with lower insulin response, 3590 ± 136 g in those with higher insulin response).Conclusions. An early insulin response to glucose associates with postnatal growth. This suggests that physiological variations in postnatal insulin secretion can influence growth and height in healthy subjects. Furthermore, in the present study group, a low birth weight is not an important determinant of postnatal insulin secretion.
Liver reactions from trimethoprim
Authors: LINDGREN A. , OLSSON R. 
Published: August 2009

Abstract. Objective. To study whether there are adverse liver reactions to trimethoprim and, if found, to describe the biochemical pattern of these reactions.Design. We surveyed all liver reactions from trimethoprim to SADRAC (Swedish Adverse Drug Reactions Advisory Committee) from 1980 to 1989.Main outcome measure. Incidence of reported adverse liver reactions [number of reported adverse liver reactions/sales of trimethoprim in defined daily dose (DDD)].Results. During 1980–1989, 21 suspected liver reactions from trimethoprim were reported. A causal relationship was considered probable in 10 of these reports, which gives an incidence of 1/1360000 DDD. The distribution of reaction types for trimethoprim was virtually identical to that found in corresponding adverse reports for trimethoprim‐sulfonamides, whereas the sulfonamides as single drugs displayed a significantly higher proportion of more severe hepatocellular reactions.
Myocardial infarct size and mortality in patients with non‐insulin‐dependent diabetes mellitus
Authors: LEHTO S. , PYÖRÄLÄ K. , MIETTINEN H. , RÖNNEMAA T. , PALOMÄKI P. , TUOMILEHTO J. , LAAKSO M. 
Published: August 2009

Abstract. Objectives. To study the infarct size and mortality in patients with non‐insulin‐dependent diabetes mellitus (NIDDM) and in non‐diabetic subjects with their first acute myocardial infarction.Design. Seven year follow‐up study of large representative cohorts of patients with non‐insulin‐dependent diabetes mellitus and non‐diabetic subjects (study 1) and the FINMONICA acute myocardial infarction register study in 1988‐89 (study 2).Setting. Populations of the districts of the Kuopio University Hospital and Turku University Central Hospital (study 1). Populations of Kuopio and North Karelia provinces and Turku/Loimaa area (study 2).Subjects. Study 1: 1059 patients with non‐insulin dependent diabetes mellitus and 1373 non‐diabetic subjects aged 45–64 years at baseline; during the follow‐up 166 patients with non‐insulin‐dependent diabetes mellitus (91 men and 75 women) and 30 non‐diabetic subjects (25 men and five women) were hospitalized for their first acute myocardial infarction. Study 2: 1622 patients aged 25–64 years hospitalized for their first acute myocardial infarction; 144 patients (90 men and 54 women) had non‐insulin‐dependent diabetes mellitus and 1153 (890 men and 263 women) were non‐diabetic.Main outcome measures. The infarct size was assessed on the basis of maximum levels of serum cardiac enzymes (studies 1 and 2) and QRS‐score (study 1).Results. No differences were found in maximum levels of serum cardiac enzymes between diabetic and non‐diabetic patients. Similarly QRS‐score gave no suggestion of a difference in infarct size between diabetic and non‐diabetic patients. In both studies mortality before hospital admission was similar in diabetic and non‐diabetic patients, but mortality within 28 days from hospital admission was twice as high in diabetic patients as in non‐diabetic patients. Cardiac failure was the main cause of death significantly more often in diabetic patients than in non‐diabetic patients (study 2).Conclusions. Poorer prognosis of acute myocardial infarction in diabetic patients appears not to be explained by a larger infarct size but probably by adverse effects of the diabetic state itself on myocardial function.
Comparison of bleeding complications of warfarin and warfarin plus acetylsalicylic acid: a study in 3166 outpatients
Authors: HURLEN M. , ERIKSSEN J. , SMITH P. , ARNESEN H. , ROLLAG A. 
Published: August 2009

Abstract. Objective. The aim of the study was to compare the incidence of bleeding complications in patients receiving warfarin alone and those receiving warfarin in combination with acetylsalicylic acid.Subjects and methods. This retrospective study comprises all outpatients in our hospital receiving warfarin (n = 3166) in the period 1 January 1986 to 31 December 1990. Of these, 2026 patients received warfarin alone, aiming at an international normalized ratio level of 4.2‐2.5, whereas the combination of warfarin and acetylsalicylic acid (150 mg daily) was given to 1140 patients, aiming at an international normalized ratio level of 2.8‐2.2. Total observation time represents 4420 treatment years.Results. A total of 175 bleeding episodes was observed, 18 of which were fatal, and 96 were serious (requiring hospitalization). The incidence of minor bleedings was significantly higher in the combined therapy group than in the group receiving warfarin alone, 2.9% and 1.4% respectively (P < 0.003). However, there was no difference in the therapy groups regarding the incidence of serious and fatal bleedings. The overall incidence of gastrointestinal bleedings was equal in the two groups.Conclusions. The combination of warfarin and aspirin 150 mg daily aiming at a less intense level of anticoagulation than in warfarin therapy alone does not increase the risk of major or fatal haemorrhage.
A long‐term, randomized, comparative study of insulin versus sulfonylurea therapy in type 2 diabetes
Authors: BIRKELAND K. I. , HANSSEN K. F. , URDAL P. , BERG K. , VAALER S. 
Published: August 2009

Abstract. Objectives. To study the effect of insulin and sulfonylurea (SU) therapy on glycaemic control, insulin resistance and cardiovascular risk factors in type 2 diabetic subjects.Design. A prospective, parallel, randomized, controlled, long‐term study.Setting. Outpatient clinic in tertiary referral centre.Subjects. Thirty‐six type 2 diabetic subjects treated with diet and SU, aged 44–69 years and a duration of diabetes of between 2 and 14 years.Interventions. Individually adjusted doses of insulin and glibenclamide.Main outcome measures. Glycosylated haemoglobin (HbA1c), insulin resistance (euglycaemic glucose clamp), levels of lipids, lipoproteins and blood pressure.Results. Glycaemic control improved during insulin treatment, but deteriorated on SU; HbA1c levels differed significantly between groups after 12 months of therapy (mean ± SEM 7.9 ± 0.3 vs. 9.5 ± 0.4%. P = 0.004). Body mass index increased significantly during insulin treatment (26.4 ± 0.7 to 27.8 ± 0.7 kg/m2, P = 0.0001) and 30% of this increase was a result of an increase in lean body mass. The total glucose disposal rate showed a small increase in the insulin group. Levels of triglycerides and apolipoprotein B were significantly reduced during insulin treatment (1.8 ± 0.2 to 1.5 ± 0.2 mmol L−1, P = 0.03 and 1.58 ± 0.1 to 1.40 ± 0.08 g L−1, P = 0.003), and insulin prevented a reduction in the levels of high‐density lipoprotein (HDL) cholesterol and apolipoprotein A‐1 and an increase in Lp(a) lipoprotein observed in the SU group. Blood pressure levels did not change during therapy.Conclusions. Insulin therapy was superior to SU treatment in achieving good metabolic control. Despite a modest improvement in cardiovascular risk factors in the insulin‐treated group, no significant differences were observed between the groups after 1 year's treatment.
Serum ferritin and transferrin saturation in patients with chronic alcoholic and non‐alcoholic liver diseases
Authors: BELL H. , SKINNINGSRUD A. , RAKNERUD N. , TRY K. 
Published: August 2009

Abstract. Objectives. To compare serum ferritin concentration and transferrin saturation in patients with alcoholic and non‐alcoholic chronic liver diseases.Design. Concecutive patients with liver diseases.Setting. The department of internal medicine in a teaching hospital.Subjects. Three hundred and twelve patients with different liver diseases concecutively admitted between 1987 and 1992.Interventions. None.Main outcome measures. Fasting serum iron, transferrin and ferritin.Results. Serum ferritin was increased above 200 μg L−1 in all 18 patients with haemochromatosis (range 310–6500 μg L−1), in 64 of 111 alcoholics (58%) and in 30 of 137 (22%) with chronic non‐alcoholic liver diseases (P < 0.01). Twelve of 111 alcoholics (11%) had serum ferritin above 1000 μg L−1 compared with one of 137 (0.7%) with chronic non‐alcoholic liver diseases. In 13 alcoholics who abstained after admission, serum ferritin decreased from 1483 μg L1 ± 1134 to 388 μg L−1 ± 237 (P < 0.001) after 1 1/2 to 6 weeks. The transferrin saturation was increased above 62% in 13 of 18 patients (72%) with haemochromatosis, in 16 of 105 alcoholics (15.2%) and in three of 132 (2.3%) with chronic non‐alcoholic liver disease (P < 0.01).Conclusion. Serum ferritin is more frequently elevated in abusing patients with alcoholic liver disease than in patients with other chronic liver diseases such as autoimmune liver diseases and hepatitis C. Because serum ferritin decreases rapidly during abstinence, the measurement of ferritin for the detection of haemochromatosis in patients abusing alcohol should be postponed until the patients are abstaining. Most of the patients with increased serum ferritin have normal transferrin saturation values which can be used to separate them from haemochromatosis.
Cardiovascular risk factors in a Melanesian population apparently free from stroke and ischaemic heart disease: the Kitava study
Authors: LINDEBERG S. , NILSSON‐EHLE P. , TERÉNT A. , VESSBY B. , SCHERSTÉN B. 
Published: August 2009

Abstract. Objectives. To compare cardiovascular risk factor levels between non‐westernized Melanesians, apparently free from stroke and ischaemic heart disease [1], and healthy Swedish populations, and to analyse, among adult Melanesians, relations with age, sex and smoking status.Design. Cross‐sectional survey.Subjects. (i) Traditional horticulturalists in Kitava, Trobriand Islands, Papua New Guinea, uninfluenced by western diet. This study tested 151 males and 69 females aged 14–87 years with 76% and 80% smokers over 20 years, (ii) Healthy Swedish reference populations.Main outcome measures. Sitting systolic and diastolic blood pressure, weight, height, body mass index, circumferences of waist, pelvis and mid upper arm, triceps skinfold thickness, fasting serum total cholesterol, triglycerides, high‐density lipoprotein cholesterol, estimated low‐density lipoprotein cholesterol, apolipoprotein B, apolipoprotein Al and apolipo‐protein (a).Results. Compared to Sweden, diastolic blood pressure, body mass index and triceps skinfold thickness were substantially lower in Kitava, where all subjects ≥ 40 years were below Swedish medians. Among males ≥ 20 and females ≥ 60 years systolic blood pressure was lower in Kitavans. Fasting serum total cholesterol, low‐density lipoprotein cholesterol and apolipoprotein B were 10–30% lower in Kitavan males ≥ 40 and females ≥ 60 years. Triglycerides were higher in Kitavans aged 20–39. High‐density lipoprotein cholesterol did not differ while apolipoprotein Al was lower in Kitavans. Apolipoprotein (a) tended to be lower in Kitavans, but the differences were small.Conclusions. Of the analysed variables, leanness and low diastolic blood pressure seem to offer the best explanations for the apparent absence of stroke and ischaemic heart disease in Kitava. The lower serum cholesterol may provide some additional benefit. Differences in dietary habits may explain the findings.
Sucralfate suspension as a treatment of recurrent aphthous stomatitis
Authors: RATTAN J. , SCHNEIDER M. , ARBER N. , GORSKY M. , DAYAN D. 
Published: August 2009

Abstract. Design. A prospective randomized, double‐blind, placebo‐controlled, cross‐over clinical trial.Setting. A university hospital.Subjects. Twenty‐one patients with symptomatic recurrent aphtous stomatitis (RAS), unresponsive to conventional treatment were enrolled. They were divided into three groups.Intervention. In a cross‐over trial, the patients received an oral suspension of sucralfate, an antacid solution or a placebo for 2 years.Results. After 2 years of follow‐up, sucralfate was found to be superior to both placebo and antacid (P < 0.001) with regard to duration of pain, reduction of the healing period, response time to first treatment and duration of remission.Conclusion. Sucralfate suspension should be added to the armament of treatment modalities of RAS.