bluuebunny/crossref_metadata_2025_split huggingface dataset:
Heart failure in the general population of men – morbidity, risk factors and prognosis
Authors: Wilhelmsen L. , Rosengren A. , Eriksson H. , Lappas G. 
Published: August 2010

Abstract. Wilhelmsen L, Rosengren A, Eriksson H, Lappas G (Göteborg University, Göteborg, Sweden). Heart failure in the general population of men – morbidity, risk factors and prognosis.J Intern Med2001;249:253–261.Aims. To analyse the prevalence, aetiology and prognosis of heart failure.Methods and results. A random population sample of men (n=7495) was examined at baseline in 1970–73 and followed until 1996. During up to 27 years, 937 men were hospitalized for heart failure. For the statistical analysis, odds ratios and 95% confidence intervals, multivariate logistic regression and time‐dependent Cox analysis were used. The incidence rate was 2.1, 9.1 and 11.5 per 1000 person‐years in the age groups 55–64, 65–74 and 75–79, and the prevalences were 0.6, 2.8 and 6.2%, respectively. Valvular heart disease was the aetiology in 5.8%, coronary heart disease only or in combination with hypertension in 58.8%, and hypertension only in 20.3%, and various combinations with diabetes in 4.5%. Of the remaining 12.1%, 96% were smokers and 64% were registered for alcohol abuse. Risk factors were increasing age, myocardial infarction in the family, diabetes mellitus, chest pain, tobacco smoking, high coffee consumption, alcohol abuse, high body mass index, high blood pressure as well as treatment for hypertension, but not high total cholesterol or psychological stress. Mortality after the diagnosis was increased eight times.Conclusions. Coronary heart disease and hypertension were the most common concomitant diseases. Risk factors were similar to those in coronary heart disease, and also alcohol abuse, but not high total cholesterol, low physical activity or psychological stress. Mortality was high.
Effective blood pressure treatment improves LDL‐cholesterol susceptibility to oxidation in patients with essential hypertension
Authors: Quiñones‐Galvan A. , Pucciarelli A. , Fratta‐Pasini A. , Garbin U. , Franzoni F. , Galetta F. , Natali A. , Cominacini L. , Ferrannini E. 
Published: August 2010

Abstract. Quiñones‐Galvan A, Pucciarelli A, Fratta‐Pasini A, Garbin U, Franzoni F, Galetta F, Natali A, Cominacini L, Ferrannini E (University of Pisa; and Istituto di Semeiotica Medica, University of Verona, Italy). Effective blood pressure treatment improves LDL‐cholestrol susceptibility to oxidation in patients with essential hypertension. J Intern Med 2001; 250: 322–326. Objectives. LDL‐cholesterol particles from hypertensive patients exhibit enhanced susceptibility to in vitro oxidation, an abnormality thought to increase cardiovascular risk. We tested whether blood pressure (BP) normalization can reverse this abnormality. Design. Double‐blind, randomized pharmacological intervention trial. Setting. Clinical research centre. Subjects. A total of 29 nondiabetic, normolipidaemic patients with essential hypertension (BP= 151 ± 3/99 ± 1 mmHg) and 11 normotensive controls (BP=125 ± 3/85 ± 1 mmHg) matched for gender, age, obesity, glucose tolerance and lipid profile. Intervention. Anti‐hypertensive treatment for 3 months with a calcium‐antagonist in randomized combination with either an ACE inhibitor or a β‐blocker. Main outcome measures. Lag phase of copper‐induced LDL oxidation, cell‐mediated (human umbilical vein endothelium) generation of malondialdehyde (MDA) by LDL and vitamin E content in LDL. Results. At baseline in hypertensives versus controls, lag phase was shorter (89 ± 3 vs. 107 ± 6 min, P < 0.04), MDA generation was higher (5.8 ± 0.1 vs. 5.1 ± 0.2 nmol L–1, P=0.002), and vitamin E was reduced (6.40 ± 0.05 vs. 6.67 ± 0.11 μg mg–1, P=0.03). At 3 months, BP was normalized (124 ± 3/81 ± 1, P < 0.0001 vs. baseline, P=ns versus controls), lag phase was prolonged (to 98 ± 3 min, P=0.0005), MDA generation was reduced (5.6 ± 0.1 nmol L–1, P = 0.001), and vitamin E was increased (6.53 ± 0.05 μg mg–1, P=0.003), with no significant differences between the randomized groups. Conclusions. In nondiabetic, nonobese, normolipidaemic patients with essential hypertension, LDL susceptibility to copper‐ and cell‐mediated oxidation is increased. BP normalization is associated with a significant improvement, but not a full reversal, of this abnormality.
Idiopathic environmental intolerances (formerly multiple chemical sensitivity) psychiatric perspectives
Authors: Bornschein S. , Förstl H. , Zilker T. 
Published: August 2010

Abstract. Bornschein S, Förstl H, Zilker T (Technische Universität München, München, Germany). Idiopathic environmental intolerances (formerly multiple chemical sensitivity) psychiatric perspectives. J Intern Med 2001; 250: 309–321.Idiopathic environmental intolerances (IEI)/multiple chemical sensitivity (MCS) is characterized by various somatic symptoms which cannot be explained organically, but are attributed to the influences of toxic environmental chemicals in low, usually harmless doses. In the absence of a widely accepted definition of IEI, contradictory aetiological hypotheses and therapeutic suggestions are discussed. Some authors doubt the existence of IEI/MCS as a disease entity of its own. The label IEI does not implicate neither a diagnosis of somatic disease nor that it is caused by an avoidable exposure. Many IEI patients suffer from psychiatric diseases. A majority of them can be diagnosed as somatoform disorders. Consequently, psychiatric therapies could be effective. This review describes the current knowledge about IEI/MCS, outlines a diagnostic algorithm and a psychotherapeutic concept for variants of IEI understood as a somatoform disorder.
Factors influencing the relation between alcohol and mortality – with focus on wine
Authors: GRØNBÆK M. 
Published: August 2010

Abstract. Grønbæk M (Kommunehospitalet, Copenhagen, Denmark). Factors influencing the relation between alcohol and mortality – with focus on wine (Review Article). J Intern Med 2001; 250: 291–308.The impact of alcohol intake on mortality has been described in a large number of prospective population studies from many countries. Most have shown a J‐shaped relation between alcohol intake and subsequent mortality, indicating that there are both beneficial and harmful effects of ethanol on health. In exploring the French paradox, it has been suggested that wine may have beneficial effects additional to that of ethanol. Recently, several prospective population studies have supported this idea. However, it is also likely that the apparent additional beneficial effect of wine on health is confounding.
Fatal adverse drug events: the paradox of drug treatment
Authors: Buajordet I. , Ebbesen J. , Erikssen J. , Brørs O. , Hilberg T. 
Published: August 2010

Abstract. Buajordet I, Ebbesen J, Erikssen J, Brørs O, Hilberg T (The Norwegian Medicines Agency, Oslo; Central Hospital of Akershus, Nordbyhagen; Ullevaal University Hospital and National Institute of Forensic Toxicology, Oslo, Norway). Fatal adverse drug events: the paradox of drug treatment. J Intern Med 2001; 250: 327–341. Objective. Study patient characteristics, morbidity patterns and drug regimens associated with fatal adverse drug events (FADEs) amongst medical department inpatients. Design. An observational, descriptive study using aggregated medical records, autopsies and pre and postmortem drug analyses. Setting. A department of internal medicine at a Norwegian county hospital. Subjects. All patients dying in the department over a 2‐year period. Results. The incidence of FADEs were 18.2% (133/732). Compared with non‐FADE cases, FADE cases were older, used more drugs both on admission and at death, and had higher comorbidity (P < 0.001). Drugs suspected to cause or contribute to fatal outcome were mainly those used for treating chronic pulmonary diseases (terbutaline, theophylline), antithrombotic drugs (aspirin, warfarin, heparines) and drugs for treating coronary heart disease and heart failure (e.g. diuretics, nitrates, angiotensin converting enzymes (ACE) inhibitors, calcium channel blockers). Bronchodilatory drugs, antithrombotic drugs and cardiovascular drugs account for 26, 31 and 30 FADE cases, respectively. Patients dying from gastrointestinal diseases had the highest relative FADE occurrence (42%), cancer patients the lowest occurrence (4%). Serious drug–drug and drug–disease interactions were frequently suspected. Various degrees of inappropriateness in choice of drug, dosage or administration route were seen in 50% of FADE cases. Conclusions. This study shows a high incidence of FADEs associated with high age, high comorbidity and polypharmacy, and partly to inappropriate drug prescribing or use. Treatments frequently associated with FADEs were bronchodilatory treatment of patients with both chronic obstructive lung disease and coronary heart disease, vasodilatory treatment in patient with endstage heart failure and the combination of several antithrombotic drugs. A systematic strategy is needed to avoid unnecessary adverse drug events (ADEs).
Prevalence of undiagnosed coeliac syndrome in osteoporotic women
Authors: Nuti R. , Martini G. , Valenti R. , Giovani S. , Salvadori S. , Avanzati A. 
Published: August 2010

Abstract. Nuti R, Martini G, Valenti R, Giovani S, Salvadori S, Avanzati A (Institute of Internal Medicine, Metabolic Disease Unit, University of Siena, Siena, Italy). Prevalence of undiagnosed coeliac syndrome in osteoporotic women. J Intern Med 2001; 250: 361–366. Objectives. The aims of the study were to quantify the prevalence of asymptomatic coeliac disease (CD) in a cohort of osteoporotic females, and to investigate the features of bone loss. Design and subjects. We studied 255 women (mean age 66.6 ± 8.5 SD) with primary osteoporosis (WHO diagnostic criteria). After the first CD screening with the measure of serum IgG antigliadin antibodies (IgG‐AGA), 53 women showed a positive test: antibodies to tissue transglutaminase (TG‐ab) were subsequently determined to confirm the diagnosis of CD. Bone metabolism was evaluated by: serum and urinary calcium, serum and urinary phosphate, serum alkaline phosphatase, urinary crosslaps, serum 25(OH)D and serum parathyroid hormone. Results. High levels of IgG‐AGA and TG‐ab were observed in 24 patients with a prevalence of serological disease of 9.4%. These women were characterized, in comparison with the other patients, by a statistically significant reduction in serum 25(OH)D (17.8 ± 7.2 vs. 55.1 ± 20.3 nmol L−1, P < 0.01) together with a significant increase of iPTH (65.1 ± 29.7 vs. 35.1 ± 20.0 pg mL−1; P < 0.01). Patients with high TG‐ab levels showed also slightly raised values of urinary crosslaps (288 ± 88 vs. 270 ± 90 μm mol−1 Cr). In IgG‐AG positive patients a statistically significant inverse correlation was found between 25(OH)D serum levels and log‐transformed TG‐ab values (r: –0.95, P < 0.001). Intestinal biopsies were obtained in 10 TG‐ab positive women and verified CD in six patients. Conclusions. These data support the hypothesis that patients with undiagnosed celiac disease develop high remodelling processes related to calcium malabsorption, secondary hyperparathyroidism and unavailability of vitamin D with a consequent more marked bone loss.
Venous thromboembolism prophylaxis in acutely ill medical patients: definite need for improvement
Authors: CHOPARD P. , DÖRFFLER‐MELLY J. , HESS U. , WUILLEMIN W. A. , HAYOZ D. , GALLINO A. , BACHLI E. B. , CANOVA C. R. , ISENEGGER J. , RUBINO R. , BOUNAMEAUX H. 
Published: August 2010

Abstract.Aim of the study.  To examine the frequency and adequacy of thromboprophylaxis in acutely ill medical patients hospitalized in eight Swiss medical hospitals.Methods.  A cross‐sectional study of 1372 patients from eight Swiss hospitals was carried out. After exclusion of patients (275) given therapeutic anticoagulation, 1097 patients were audited. The adequacy of thromboprophylaxis was assessed by comparison with predefined explicit criteria.Results.  Of 1097 patients, 542 (49.4%) received thromboprophylaxis. According to the explicit criteria, 644 (58.7%) should have been on prophylaxis (P < 0.001, when compared with the rate observed). The rate of prevention differed widely between hospitals (from 29.4 to 88.6%) with no difference between teaching and nonteaching hospitals. According to the explicit criteria, a substantial proportion (44.9%) of the patients who should have been treated were not. Conversely, 41.3% of the patients were unnecessarily treated.Conclusions.  Even though the appropriateness of the explicit criteria used could be challenged, our data suggest that the current practice is associated with important uncertainty leading to both overuse and underuse of thromboprophylaxis in patients hospitalized in medical wards. More efforts are urgently needed to develop new or endorse existing explicit, evidence‐based criteria and guidelines for thromboprophylaxis in this population of patients.
Dietary habits after myocardial infarction – results from a cross‐sectional study
Authors: WALLSTRÖM P. , MATTISSON I. , TYDÉN P. , BERGLUND G. , JANZON L. 
Published: August 2010

Abstract.Objective.  Comparing habitual nutrient intakes in persons with a history of acute myocardial infarction (AMI), and age‐matched controls.Design.  Cross‐sectional study.Subjects.  Men and women (525 cases and 1890 matched controls), aged 47–73 years, of the population‐based Malmö Diet and Cancer cohort.Methods.  Nutrient intakes were assessed by a validated modified diet history method. Body fatness was assessed by bioimpedance analysis. Case ascertainment was provided by national and regional registries. Men and women were analysed separately. Median time since AMI was 5.5 years in men and 3.8 years in women. Cases reported lower energy intakes (EIs) than controls, despite having similar basal metabolic rates. After adjustment for total EI, both male and female cases had lower fat intake and higher intake of several micronutrients, such as ascorbic acid, folate, and vitamin E, than controls, the difference being largest in men. Most of the cases reporting dietary change quoted ‘disease’ as their main reason for change. They had lower EI and lower energy‐adjusted intake of fat than other cases.Conclusions.  Survivors of AMI reported dietary habits more in line with current recommendations, particularly those who afterwards reported having changed their dietary habits. The possible bias introduced by social desirability is discussed.
Homocysteine levels are not associated with cardiovascular autonomic function in elderly Caucasian subjects without or with type 2 diabetes mellitus: the Hoorn Study
Authors: SPOELSTRA‐DE MAN A. M. E. , SMULDERS Y. M. , DEKKER J. M. , HEINE R. J. , BOUTER L. M. , NIJPELS G. , STEHOUWER C. D. A. 
Published: August 2010

Abstract.Objective.  Homocysteine and cardiovascular autonomic function are both predictors of cardiovascular disease and death, particularly in patients with diabetes. The mechanism by which homocysteine causes disease is unknown. The objective of our study was to determine whether hyperhomocysteinaemia is associated with impaired cardiovascular autonomic function in an age‐, sex‐, and glucose tolerance‐stratified sample of an elderly Caucasian population.Methods.  We studied 609 subjects, 252 with normal glucose metabolism, 173 with impaired glucose metabolism, and 184 with type 2 diabetes. Cardiac cycle duration (RR interval) and continuous finger arterial pressure were measured under three conditions: during (i) spontaneous breathing, (ii) six deep breaths over 1 min, and (iii) an active change in position from lying to standing. From these readings, 10 parameters of autonomic function were assessed (three Ewing tests, six heart rate variability tests and one test of baroreflex sensitivity). These 10 measurements were summarized in a single cardiovascular autonomic dysfunction score (CADS).Results.  Comparing values of autonomic function measures in the lowest versus the highest quartile of homocysteine revealed no significant association between homocysteine level and autonomic function in the whole study group, nor in the individual glucose tolerance groups. Multiple adjustment for age, sex, waist‐to‐hip ratio, serum creatinine, use of antihypertensives and fasting insulin, confirmed this result. We found no evidence of effect modification of glucose tolerance status on the association between homocysteine and autonomic dysfunction (P for interaction for CADS = 0.79).Conclusions.  There is no evidence for an association between homocysteine levels and cardiovascular autonomic function in either diabetic or nondiabetic subjects. Cardiovascular autonomic dysfunction does not help explain why hyperhomocysteinaemia is related to cardiovascular mortality.
Reduced positive affect (anhedonia) predicts major clinical events following implantation of coronary‐artery stents
Authors: Denollet J. , Pedersen S. S. , Daemen J. , De Jaegere P. , Serruys P. W. , Van Domburg R. T. 
Published: August 2010

Abstract.Objective.  Emotional distress has been related to clinical events in patients with coronary artery disease, but the influence of positive affect (i.e. mood states such as activity, joy and cheerfulness) has received little attention. Therefore, we wanted to investigate the role of positive affect on clinical outcome after percutaneous coronary intervention (PCI) with stent implantation in these patients.Design.  Prospective follow‐up study. At baseline, patients from the Rapamycin‐Eluting Stent Evaluated At Rotterdam Cardiology Hospital (RESEARCH) registry completed measures of positive affect, depression and anxiety post‐PCI. Patients with reduced positive affect scored 1 SD below the mean score.Setting.  University Hospital; Thoraxcenter of the Department of Cardiology.Subjects.  874 patients (72% men; 62.2 ± 10.9 years) from the RESEARCH registry.Main outcome measure.  Death or myocardial infarction (MI) 2 years post‐PCI.Results.  At follow‐up, there were 52 clinical events (deaths n = 27, MIs n = 25). Reduced positive affect and depression/anxiety were associated with poor prognosis, but reduced positive affect was the only independent predictor of events. The incidence of death/MI in adequate versus reduced positive affect patients was 4% (29/663) vs. 11% (23/211); HR = 2.55 (95% CI 1.46–4.34, P = 0.001), adjusting for clinical variables. Reduced positive affect and diabetes were independent prognostic factors, and patients with one (HR = 2.84, 95% CI 1.58–5.10) or both (HR = 5.61, 95% CI 2.25–13.99) of these factors had a higher risk when compared with nondiabetic patients with adequate positive affect, P ≤ 0.003.Conclusions.  Reduced positive affect independently predicted death/MI following stent implantation, and improved risk stratification above and beyond diabetes.
Two SNPs in the promoter region of the CTLA‐4 gene affect binding of transcription factors and are associated with human myasthenia gravis
Authors: Wang XB. , Pirskanen R. , Giscombe R. , Lefvert A. K. 
Published: August 2010

Abstract.Objectives.  The molecular mechanisms underlying the regulation of the CD152 (CTLA‐4) gene are largely unknown. Two single nucleotide polymorphisms (SNPs) located in the promoter region are suspected to contribute to the pathogenesis of myasthenia gravis (MG) through regulation of gene expression.Setting, Subjects and Design.  One hundred and sixty‐five unrelated Swedish‐Caucasian patients with MG (103 females and 62 males, age 17 to 92 years) and 148 ethnically matched healthy individuals were studied. Gene typing of two SNPs (T/C−1772 and A/G−1661) and quantification of soluble CD152 were performed in the patients. Besides the association studies, the function of these two SNPs is characterized.Results.  We present new genetic associations of two SNPs in the CD152 gene with human MG. These SNPs located in the promoter region are involved in transcriptional binding activity for Nuclear Factor I (NF‐1) and c/EBPbeta, as demonstrated using chromatin immunoprecipitation and electromobility shift assay. MG patients with the T/C−1772 polymorphism have elevated levels of sCD152 in sera.Conclusions.  The two SNPs in the promoter region are associated with MG and might cause abnormal alternative splicing and affect the expression of CD152, thereby contributing to the pathogenesis of MG.
Antitissue transglutaminase antibodies in acute coronary syndrome: an alert signal of myocardial tissue lesion?
Authors: Di Tola M. , Barillà F. , Trappolini M. , Palumbo H. F. , Gaudio C. , Picarelli A. 
Published: August 2010

Abstract.Background and aim.  Antitransglutaminase, previously considered identical to antiendomysial in coeliac sprue (CS), have been reported in end‐stage heart failure. To clarify the above‐mentioned data, we evaluated these antibodies in a cohort of cardiological patients with respect to troponin I, creatine kinase (CK), MB fraction creatine kinase (CK‐MB mass) and myoglobin.Methods.  Forty‐one patients with acute coronary syndrome (ACS), 39 with dilated cardiomyopathy (DCM), 45 with CS and 58 blood donors (BDs) were evaluated. Antitransglutaminase and antiendomysial antibodies were tested in serum of the patients being studied.Results.  High‐positive antitransglutaminase values were found in CS, whilst low‐positive values were also found in ACS and DCM. In patients at the second ACS, antibody levels were higher than in those at the first cardiac event. In patients with infarct Q, antitransglutaminase were higher than those in infarct non‐Q, in which antibody levels were higher than those in unstable angina. A correlation between antitransglutaminase and troponin I, CK, CK‐MB mass and myoglobin was found. Finally, antibody levels rose to reach a peak at 30 days from the cardiac event, whereas after further 150 days, approached the values of BDs. Antiendomysial were detectable only in CS.Conclusions.  Data highlight that antitransglutaminase can occur in cardiological patients, and that these antibodies are related to the severity/extent of the myocardial tissue lesion. This feature suggests a loss of specificity for antitransglutaminase in CS. Furthermore, the possibility of employing these antibodies in the long‐term follow‐up of ACS, could become an object of interesting discussion.
Understanding ageing from an evolutionary perspective
Authors: Kirkwood T. B. L. 
Published: August 2010

Abstract.There is clear heritability of human longevity. However, the genetics of ageing is likely to be complex. Evolution theory tells us not to expect genes that have been selected to promote ageing. Ageing is not programmed but results from accumulation of somatic damage, owing to limited investments in maintenance and repair. Genes controlling the levels of activities, such as DNA repair and antioxidant defence, thus regulate longevity. In addition, there may be contributions either from late‐acting deleterious genes that escape the force of natural selection or that trade benefit at an early age against harm at older ages. In some species, there is evidence that genes have evolved to detect and respond to changes in the environment, e.g. food supply. Evolutionary understanding can also help to understand important features of the human life history such as menopause.