bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tracking of cardiovascular disease risk factors including maximal oxygen uptake and physical activity from late teenage to adulthood An 8‐year follow‐up study
Authors: ANDERSEN L. B. , HARALDSDÓTTIR J. 
Published: August 2009

Abstract. Objectives. The aim of the study was to analyse changes in coronary heart disease (CHD) risk factors from adolescence to young adulthood, and how changes in risk factors relate to changes in lifestyle.Design. A randomized sample of school children was tested in 1983 and followed‐up 8 years later. In 1983 a dropout of 0.7% was found and the sample was representative of 16–19‐year‐old Danes.Subjects. Subjects followed‐up 8 years later (two‐thirds of the original sample) were 88 male and 115 female 15–19‐year‐old school children attending 18 high schools, nine vocational and nine trade schools, throughout Denmark.Main outcome measures. Height, body weight, body fat, occupation and coronary heart disease risk factors including physical activity (PA), fitness, blood pressure (BP), serum cholesterol, HDL cholesterol, triglyceride (TG) and smoking habits were assessed.Results. In males all risk factors increased: the increases in total cholesterol level and systolic and diastolic BP were large, 0.85 mmol l−1 and 11 mmHg, respectively. In females, the risk for some factors increased (total cholesterol and BP), others decreased (higher HDL cholesterol), and triglyceride did not change. Significant tracking was found in both sexes, with the highest correlation coefficients in men. A total risk score was calculated by categorizing risk factors into six groups—1 to 6—and then adding the scores. Pearson correlation between the total risk scores in 1983 and 1991 in men was r = 0.67 (P < 0.001). Only a weak association was found for the total risk score in women. Nearly 50% of the boys, who were initially in the upper quintile of risk, were still in the upper quintile 8 years later for most risk factors. In men, the changes in risk factors were related to social factors. Blue‐collar workers and the unemployed had the highest increase in risk factors, and the largest decrease in Vo2max (ml min−1 kg−1) when analysed together. In both sexes the best relationship between 1983 and 1991 values was found in body mass index (BMI). Leisure time physical activity (PA) and triglyceride (TG) had a low correlation between 1983 and 1991 values. Physical activity had a non‐significant correlation over time for women, indicating that PA in 1983 did not predict PA in 1991 at all.Conclusion. Coronary heart disease risk factors tracked in both males and females, but only in males was a strong relationship found for total risk from adolescence to young adulthood, indicating the influence of a poor lifestyle in high‐risk men. Lower social status related to higher risk.
Venographic assessment of deep vein thrombosis and risk of developing post‐thrombotic syndrome: a prospective study
Authors: MONREAL M. , MARTORELL A. , CALLEJAS J. M. , VALLS R. , LLAMAZARES J. F. , LAFOZ E. , ARIAS A. 
Published: August 2009

Abstract. It is well known that patients with deep vein thrombosis (DVT) constitute a risk group for development of pulmonary embolism. However, the relation of DVT and the extent thereof with the subsequent sequelae (post‐thrombotic syndrome) are insufficiently investigated. We have prospectively studied a series of consecutive patients admitted because of DVT on lower limbs, trying to correlate venographic findings during acute DVT with post‐thrombotic (PTS) symptoms that develop later.Seventy‐nine patients (84 limbs) with acute DVT were followed‐up in our out‐patient clinic at 4‐monthly intervals for 3 years. At each visit patients were carefully examined regarding the appearance of PTS symptoms and/or signs from the DVT‐affected leg. Three years after discharge, presence of PTS signs was assessed according to a simple scoring system. And then correlated to venographic findings during acute DVT.Patients were classified as having no (37 legs), mild (30 legs), or severe PTS signs (17 legs). Patients with popliteal vein involvement showed a significantly higher incidence of PTS 3 years later (P < 0.001). The risk of PTS also increased as DVT extent increased (P < 0.001). Nevertheless, the logistic regression analysis showed that DVT location explained all the differences (P < 0.001). In other words, DVT extent was overriden by the significance of DVT location, being popliteal the only location that showed a relevant contribution to the PTS incidence (95% confidence interval = 2.49–71.5).
Effects of alcohol intake and obesity on serum liver enzyme activity in obese men with mild hypertension
Authors: FAGERBERG B. , LINDSTEDT G. , BERGLUND G. 
Published: August 2009

Abstract. Objectives. To examine the relationships between alcohol intake, obesity, plasma insulin concentration and serum activities of three liver enzymes in obese men with mild hypertension.Design. A 6‐week run‐in period followed by randomization to either diet treatment or antihypertensive drug treatment, lasting for 1 year. Alcohol intake was estimated using questionnaires. Plasma insulin concentration, serum activities of gamma‐glutamyl transferase, and aspartate and alanine aminotransferase, respectively, were measured at entry and after 1 year.Setting. Out‐patient clinic, city hospital.Patients. Sixty‐four men aged 40–69 years with a body mass index > 26 kg m−1 and with mild untreated hypertension. Exclusion criteria were alcoholism and diabetes mellitus. Sixty‐one patients completed the study.Interventions. Dietary treatment was based upon weight reduction and recommendations about a low alcohol intake. Drug treatment used a stepped‐care approach with atenolol as the first‐choice drug.Main outcome measures. Serum activities of the liver enzymes, body weight, body mass index, alcohol intake, plasma insulin concentration.Results. Body weight decreased by 7.8 kg in the diet group and increased by 1.0 kg in the drug‐treated group. Alcohol intake did not differ between the groups before or after 1 year. Serum gamma‐glutamyl transferase activity correlated with alcohol consumption; it showed no significant change after weight loss. At entry, serum activities of aspartate and alanine aminotransferases correlated to plasma insulin concentration independent of body mass index. Weight reduction significantly lowered serum activities of these liver enzymes as well as plasma insulin concentrations and normalized elevated serum activity of alanine aminotransferase in a majority of the cases.Conclusion. Alcohol intake was an important determinant for elevated serum gamma‐glutamyl transferase activity. The degree of obesity was a contributing factor for elevations of serum alanine aminotransferase activity. We speculate that insulin may play a role in this relationship.
Long‐term prognosis for diabetic patients with foot ulcers
Authors: APELQVIST J. , LARSSON J. , AGARDH C.‐D. 
Published: August 2009

Abstract. Objective. To evaluate the recurrence of foot ulcers as well as the cumulative amputation and mortality rates in diabetic patients with previous foot ulcers.Design. A prospective study of consecutively presenting diabetic patients admitted to the Department of Internal Medicine because of foot ulcer with a median follow‐up of 4 years.Setting. A multidisciplinary foot‐care team.Population. Five‐hundred‐and‐fifty‐eight consecutive diabetic patients with foot ulcers treated between 1 July 1983 and 31 December 1990 were followed to final outcome. Out of these patients, 468 healed either primarily (n = 345) or after minor or major amputations (n = 123) and 90 died before healing had occurred. Those 468 patients who healed were included in this prospective study from the time of healing.Main outcome measures. Patients were followed according to a standardized protocol with registration of foot lesions, amputation, morbidity and mortality. Clinical examination was performed twice yearly.Results. After 1, 3 and 5 years of observation 34%, 61% and 70% of the patients, respectively, had developed a new foot ulcer. The recurrence rate of foot lesions was slightly higher among patients who previously had had an amputation (P < 0.05, P < 0.01 and non‐significant, respectively). Among patients with previous primary healing the cumulative amputation rates were 3%, 10% and 12% after 1, 3 and 5 years of follow‐up compared with 13%, 35% and 48% among those who previously healed after amputation, irrespective of previous amputation level (P < 0.001 at all time‐points). All amputations except three were initiated by a foot ulcer deteriorating to deep infection or progressive gangrene. The long‐term survival ratio was lower among patients healed after previous amputation (80%, 59%, 27%) compared with patients with previously primary healing (92%, 73%, 58%) after 1, 3 and 5 years of observation, respectively (P < 0.001. P < 0.01 and P < 0.001 respectively). The mortality rate was twice as high among primarily healed and four times as high among patients with amputation compared to an age‐ and sex‐matched Swedish population.Conclusion. These findings stress the need for life‐long surveillance of the diabetic foot at risk and the necessity of preventive foot care among diabetic patients with previous foot lesions, and particularly among those who had had a previous amputation.
Intraplaque haemorrhage at carotid artery surgery ‐ a predictor of cardiovascular mortality
Authors: FALKE P. , MÄTZSCH T. , STERNBY N. H. , BERGQVIST D. , STAVENOW L. 
Published: August 2009

Abstract. Objective. To ascertain whether carotid intraplaque haemorrhage (IH) in patients undergoing carotid artery surgery is a predictor of increased cardiac mortality over a 5.5 year follow‐up.Design and subjects. Carotid artery plaques were obtained at surgery from 47 consecutive patients (41 men. six women), median age 67 (range 48–81) years, with symptoms of carotid transient ischaemic attacks (TIAs) or carotid territory minor stroke. As determined at preoperative angiography, the degree of stenosis was 50–99%. Specimens were classified histologically as manifesting severe atherosclerosis, fibrous plaque, IH, or residual IH debris.Setting. Medical Angiology and Vascular Surgery Units, Malmö General Hospital.Intervention. Carotid endarterectomy.Main outcome measure. Correlation between mortality and IH.Results. At follow‐up after 5.5 years, mortality was 28% (13/47) overall, 92% (12/13) in the IH subgroup [of stroke (n = 1) or myocardial infarction (n = 11)], but only 3% (1/34), of pancreatic cancer, in the non‐IH subgroup (P = 0.0001). Mortality was also significantly higher in the severe atherosclerosis than in the fibrous plaque subgroup, 39% (12/31) vs. 6% (1/16) (P = 0.044), but not significantly increased in any other subgroup (fibrous plaque, residual IH, TIA, minor stroke, or acetylsalicylic acid or anticoagulant treatment). No correlation existed between IH or death and haemoglobin value or platelet count.Conclusions. Evidence of recent IH seen at carotid artery surgery may be a marker of cardiovascular mortality. As IH was also found in a post‐mortem control subgroup, the difference may be due to abnormality in blood components (e.g., coagulation factors) or impaired vessel‐wall healing capacity (e.g. endothelial dysfunction).
Short‐term treatment of Graves' disease with methimazole in high versus low doses
Authors: JORDE R. , YTRE‐ARNE K. , STØRMER J. , SUNDSFJORD J. 
Published: August 2009

Abstract. Objectives. To compare the relapse rates in Graves' disease the first 2 years after methimazole 60 mg day−1 combined with thyroxine versus a titration regimen with methimazole alone, and to look for possible prognostic factors.Design. A randomized, open, prospective study. Methimazole was given for 6 months in both groups, and thyroid status evaluated every 3rd month during the first year, and every 6th month during the second year.Setting. The study was performed at our outpatient clinic with patients referred from primary care.Subjects. Fifty‐six patients were included. One became pregnant and one dropped out during the treatment period. Furthermore, nine patients in the high‐dose and four in the low‐dose group stopped the treatment because of side‐effects. Thus, 19 patients in the high‐ and 22 in the low‐dose group completed 6 months with methimazole.Results. In those tolerating the treatment, the relapse rates in the high‐ and low‐dose groups were 26.3 vs. 59.1% (P < 0.05), 42.1 vs. 77.3% (P < 0.02); and 57.9 vs. 77.3% (NS) after 3, 12 and 24 months, respectively. The corresponding relapse rates calculated on an ‘intention to treat’ basis were: 51.7 vs. 66.7%; 62.1 vs. 81.5%; 72.4 vs. 81.5% (NS). The thyroid volume was significantly (P < 0.05) larger in those that relapsed (17.8 ± 2.9 vs. 11.6 ± 1.2 mL; mean ± SEM).Conclusions. In those tolerating the treatment, methimazole significantly reduced the relapse rate the 1st year when given in a high dose. However, the relapse rates in both groups, and the number of side‐effects in the high‐dose group, were unacceptably high.
Disturbed energy balance in skeletal muscle of patients with untreated primary hypertension
Authors: RONQUIST G. , SOUSSI B. , FRITHZ G. , SCHERSTÉN T. , WALDENSTRÖM A. 
Published: August 2009

Abstract. Objective. It has been shown that the distribution of Na+ and Ca2+ in various cells is abnormal in patients with untreated primary hypertension, indicating an altered membrane permeability in these cells. This would activate certain ion pumps and thereby enhance ATP turnover. We investigated possible alterations in energy economy of skeletal muscle tissue.Design. Skeletal muscle energetics were studied in vitro and in vivo in patients with untreated primary hypertension. Phosphocreatine (PCr), energy charge (EC) and total adenylate values were assessed.Setting. The study was performed at the outpatient clinic of a general hospital and at a university clinical chemistry department and at a specialized bioenergetic laboratory.Subjects. Altogether, 17 patients with untreated primary hypertension were examined together with matched, healthy and normotensive controls with normal body‐mass index.Main outcome measures. Skeletal muscle biopsies were obtained from 10 patients and 10 controls for analysis of high energy phosphate compounds. Another seven patients were enrolled for in vivo NMR spectroscopy.Results. We found a decrease of 30% (P < 0.01) of PCr content in the patients, whilst EC and total adenylates were unchanged. Nuclear magnetic resonance spectroscopy showed an abnormal decrease of PCr during exercise followed by a markedly slower regeneration of PCr during post‐exercise recovery parallelled by a slower recovery of pH. This phenomenon was mirrored by a more pronounced decrease of ATP/Pi in patients during exercise and a slower recovery of ATP/Pi.Conclusion. The data are compatible with an increased ATP turnover in skeletal muscle cells of patients with untreated primary hypertension although ATP was favoured and kept at a normal resting level at the expense of the PCr store.
Body iron stores, dietary iron intake and coronary heart disease mortality
Authors: REUNANEN A. , TAKKUNEN H. , KNEKT P. , SEPPÄNEN R. , AROMAA A. 
Published: August 2009

Abstract. Objectives. To assess whether increased body iron stores and dietary iron intake are associated with an increased risk of coronary heart disease mortality.Design. A prospective population study with a mean mortality follow‐up time of 14 years.Setting. Participants attending a health screening examination carried out in several localities in Finland.Subjects. All 6086 men and 6102 women aged from 45 to 64 years at the baseline examination without known heart disease, who had had serum iron and total iron binding capacity (TIBC) assessed. In a random fifth of these people, dietary iron intake was assessed by a dietary history.Interventions. The study was observational without any interventions.Main outcome measures. Mortality from coronary heart disease.Results. Altogether, 739 of the men and 245 of the women died from coronary heart disease. No relationship between TIBC and coronary mortality was observed in the men; in the women, an inverse although not significant association was found. Transferrin saturation was inversely but not significantly associated with coronary mortality in men; in women, the relationship was U‐formed with a higher mortality at both the lower and higher ends of the distribution. Adjustment for other risk factors did not alter the results. No association was found with dietary iron intake and coronary mortality.Conclusions. The results do not corroborate earlier findings that excess body iron stores and increased iron intake are associated with an elevated risk of coronary heart disease.
Effect of gemfibrozil on the regulation of HDL subfractions in hypertriglyceridaemic patients
Authors: Kahri Juhani , SANE T. , VAN TOL A. , TASKINEN M.‐R. 
Published: August 2009

Abstract. Objectives. To study changes of HDL subfractions and their regulation during gemfibrozil treatment in hypertriglyceridaemia.Design. Twenty patients with hypertriglyceridaemia were randomized to receive either 1200 mg day‐1gemfibrozil or placebo for 3 months. After a 6‐week, single‐blind placebo period, the patients were randomized to receive either gemfibrozil or placebo for 3 months in a double‐blind study.Setting. The patients were studied as outpatients in the Third Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland.Main outcome measures. Ultracentrifugally isolated HDL subclasses; concentrations of apoA‐I, apoA‐II, LpA‐I and LpA‐I: A‐II particles; post‐heparin plasma lipoprotein lipase (LPL), hepatic lipase (HL) and plasma cholesteryl ester transfer protein (CETP) activities; phospholipid transfer protein (PLTP) and lecithine cholesteryl acyltransferase (LCAT) activities were measured in plasma from six patients from both groups.Results. Gemfibrozil increased the concentration of HDL cholesterol (+ 11.1%) because of the rise of HDL3 cholesterol (34.5%, P < 0.01). The concentration of LpA‐I particles was reduced during gemfibrozil treatment (–12.4%, P < 0.05), while that of apoA‐II increased (+ 12.3%, P < 0.01). The LpA‐I to LpA‐I:A‐II ratio decreased significantly in the gemfibrozil group (–18.9%, P < 0.01). Gemfibrozil increased LPL and HL activities by 18.2% (P < 0.05) and by 19.6%, respectively. Plasma CETP activity was also increased during gemfibrozil treatment (+15.8%, P < 0.05).Conclusion. The gemfibrozil‐induced elevation of HDL3 and apoA‐II may reflect the combined action of LPL, HL and CETP on plasma HDL metabolism.
Prorenin and renal function in NIDDM patients with normo‐ and microalbuminuria
Authors: Nielsen Søren , SCHMITZ A. , DERKX F. H. M. , MOGENSEN C. E. 
Published: August 2009

Abstract. Objectives. To assess whether prorenin is elevated and perhaps a predictor of deteriorations in albuminuria and/or renal function in NIDDM patients with normo‐ and microalbuminuria.Design. A cross‐sectional and a longitudinal study.Setting. Outpatient diabetic clinic.Subjects. Twenty‐eight NIDDM patients (16 with normoalbuminuria, 12 with microalbuminuric) and 16 healthy subjects, matched for sex, age and BMI. Fifteen patients were reinvestigated after (mean [range]) 3.1 (2.1–4.3) years.Main outcome measures. Serum prorenin and renin, urinary albumin excretion rate, and glomerular filtration rate.Results. Serum prorenin was similar in both normoalbuminuric (116 × / ÷ 1.9 μU ml‐1(geometric mean × / ÷ antilog SD) and microalbuminuric (124 × / ÷ 1.7 μU ml‐1) as well as in healthy control subjects (90 × / ÷ 1.7 μU ml‐1). Prorenin did not correlate to either urinary albumin excretion rate or glomerular filtration rate. No difference between baseline and follow‐up levels of albuminuria, glomerular filtration rate or prorenin were observed. The annual changes in albuminuria, glomerular filtration rate and prorenin were not correlated, and no correlation was found between baseline prorenin levels and annual changes in albuminuria or glomerular filtration rate.Conclusions. Serum prorenin levels are not elevated in either normoalbuminuric or microalbuminuric NIDDM patients, and serum prorenin is not a valid predictor of long‐term changes in albuminuria in this patient group.
Nitric oxide modulates the discharge rate of basal forebrain neurones: a study in freely moving rats
Authors: KOSTIN ANDREY , STENBERG DAG , PORKKA‐HEISKANEN TARJA 
Published: August 2009

SummaryIn urethane‐anaesthetized rats the infusion of a nitric oxide (NO)‐donor [NOC‐18, 1 mM (DETA/NO); 2,2’‐(hydroxynitrosohydrazino)bis‐ethanamine)] into the basal forebrain (BF) inhibited the discharge rate of most neurones, suggesting that NO may promote sleep via inhibition of wake‐promoting neurones in the BF. However, this hypothesis still needs to be confirmed in freely moving rats. The objective of this study was to examine whether NO modulates the discharge rate of BF neurones in freely moving rats in a similar manner to anaesthetized rats. We measured the discharge rates of BF neurones in freely moving rats during microdialysis infusion of a NO‐donor (1 mm; NOC‐18) in different vigilance states. Neurones were characterized as wake (W)‐on (51.8%), W‐off (28.6%) and W/non‐rapid eye movement (REM)‐independent (21.4%) based on their discharge profiles during wakefulness (W) and non‐REM sleep. The NO‐donor affected the discharge rate of most BF neurones during quiet wakefulness (QW; 55%) and non‐REM sleep (64%). The most prominent response in all neuronal groups was a decrease in the discharge rate during QW and non‐REM sleep. A small subpopulation of neurones increased the discharge rate. The increase in NO in the BF during prolonged wakefulness may facilitate sleep via inhibition of wake‐promoting neurones.
Cannabinoid signalling in the enteric nervous system
Authors: Galligan J. J. 
Published: August 2009

Abstract  Cannabinoid signalling is an important mechanism of synaptic modulation in the nervous system. Endogenous cannabinoids (anandamide and 2‐arachidonyl‐glycerol) are synthesized and released via calcium‐activated biosynthetic pathways. Exogenous cannabinoids and endocannabinoids act on CB1 and CB2 receptors. CB1 receptors are neuronal receptors which couple via G‐proteins to inhibition of adenylate cyclase or to activation or inhibition of ion channels. CB2 receptors are expressed by immune cells and cannabinoids can suppress immune function. In the central nervous system, the endocannabinoids may function as retrograde signals released by the postsynaptic neuron to inhibit neurotransmitter release from presynaptic nerve terminals. Enteric neurons also express CB receptors. Exogenously applied CB receptor agonists inhibit enteric neuronal activity but it is not clear if endocannabinoids released by enteric neurons can produce similar responses in the enteric nervous system (ENS). In this issue of Neurogastroenterology and Motility, Boesmans et al. show that CB1 receptor activation on myenteric neurons maintained in primary culture can suppress neuronal activity, inhibit synaptic transmission and mitochondrial transport along axons. They also provide initial evidence that myenteric neurons (or other cell types present in the cultures) release endocannabinoids and which activate CB1 receptors constitutively. These data provide new information about targets for cannabinoid signalling in the ENS and highlight the potential importance of CB receptors as drug targets. It is necessary that future work extends these interesting findings to intact tissues and ideally to the in vivo setting.