bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationships between plasma levels of catecholamines and neuropeptides and the survival time in patients with congestive heart failure
Authors: VALDEMARSSON S. , BERGDAHL A. , EDVINSSON L. 
Published: August 2009

Abstract. Objectives. To evaluate the importance of various variables reflecting neuroendocrine activation in relation to prognosis in patients with congestive heart failure (CHF).Design. Plasma levels of noradrenaline, adrenaline, neuropeptide Y, substance P, calcitonin gene‐related peptide, vasopressin and atrial natriuretic peptide were measured in patients presenting with CHF and related to survival time. Survival time was calculated from the time‐point of this investigation until the month when the patient died or until December 1992. The follow‐up period ranged up to 60 months. Seven of the 31 patients were still alive at the end of this period.Setting.Lund University Hospital, Sweden.Subjects. Thirty‐one patients with CHF due to ischaemic heart disease. Six patients had a degree of heart failure corresponding to NYHA I‐II and 25 corresponding to NYHA III‐IV. Ten of these 25 patients were on angiotensin converting enzyme (ACE) inhibition in addition to therapy with digoxin and diureutics. The catecholamine and neuropeptide levels were compared to those of a control group of 31 healthy subject aged 20–80 years.Intervention. There were not any specific intervention in addition to the treatment for heart failure as outlined above.Main outcome measures. Survival time until death from heart disease or until the end of the follow up period in December 1992.Results. There were inverse relationships between survival time on one hand and plasma values of noradrenaline (r = ‐ 0.49: P < 0.01) and atrial natriuretic peptide (r = ‐0.49: P < 0.01) on the other hand. There was a significant correlation between the plasma values of noradrenaline and atrial natriuretic peptide (r = 0.50: P < 0.01).Conclusion. Increased plasma levels of noradrenaline and atrial natriuretic peptide are of major importance as prognostic markers in patients with CHF.
The relationship of fasting insulin levels to vascular risk factors in a general practice in Northern Ireland
Authors: BEATTY O. L. , ATKINSON A. B. , BROWNE J. , CLARKE K. , SHERIDAN B. , BELL P. 
Published: August 2009

Abstract. Objective. To investigate the relationship between insulin and vascular risk factors in a healthy male population at high risk of ischaemic heart disease.Design. Computer‐generated random number selection of subjects.Setting. A suburban general practice population (total practice population 4500) in Northern Ireland. Subjects. Four hundred male subjects, aged 35–65 years, were randomly selected with 273 responding. Intervention. At interview, each subject completed a questionnaire, had blood pressure measured and a 12‐lead ECG recorded. The next morning, fasting blood samples were taken and a timed overnight urine collection for the albumin excretion rate was returned.Results. To exclude the confounding effects of other variables on insulin concentrations, a healthy nonobese, nondiabetic, normotensive group with no history of ischaemic heart disease, no family history of diabetes and not taking drugs was identified (n = 120). Within this group there was a significant correlation between insulin and triglyceride (r = 0.30; P < 0.05), high‐density lipoprotein (HDL) cholesterol (r = 0.24: P < 0.05) and glucose (r = 0.30: P < 0.05). A group with higher insulin levels (n = 22) were compared to a group with lower insulin levels (n = 22). Serum triglyceride was higher (1.29 ± 0.1 vs. 1.00 ± 0.08 mmol L‐1; P < 0.05), HDL cholesterol was lower (1.26 ± 0.06 vs. 1.50 ± 0.09 mmol L‐1; P < 0.05) and plasma glucose higher (5.2 ± 0.1 vs. 4.9 ± 0.1 mmol L‐1; P < 0.05) in the group with higher insulin levels.Conclusions. There is a relationship between insulin and triglyceride, HDL cholesterol and glucose but not blood pressure, cholesterol or low‐density‐lipoprotein (LDL) cholesterol in a healthy population at high risk of ischaemic heart disease.
Paralytic ileus as a result of diltiazem treatment
Authors: MANTZOROS C. S. , PRABHU A. S. , SOWERS J. R. 
Published: August 2009

Abstract. Diltiazem is a widely used calcium channel blocker, and has been found to be effective in the treatment of hypertension, stable, variant and unstable angina, as well as oesophageal spasm. Calcium channel antagonists have been shown to diminish the contractility of gut smooth muscle, but have not as yet been reported to cause clinically significant inhibition of gut motility when used alone.We report a case of reversible functional intestinal obstruction, immediately following diltiazem treatment in a patient with ischaemic heart disease.
Hypertension and renal disease in patients with acute intermittent porphyria
Authors: ANDERSSON C. , LITHNER F. 
Published: August 2009

Abstract. Objectives. To assess the association between acute intermittent porphyria (AIP), hypertension and renal disease.Design. A population‐based matched case‐control study (1:4) in 50 AIP patients (manifest/latent 25/25), a retrospective study of all individuals who died between the years 1978 and 1990 (2122 including 33 with AIP) and a group of eight patients with severe AIP.Results. Hypertension was found in 56% of patients with manifest AIP, 33% of their controls (P = 0.041) and 16% of patients with latent AIP (P = 0.004). Renal disease was not more common in patients with AIP than in their controls. Three of the eight patients with severe recurrent AIP had impaired renal function, caused in one by systemic lupus erythematosus (SLE) nephritis. In the other two, no cause other than AIP could be found. In the mortality study, hypertension was registered in 68% of patients with manifest AIP compared to 21% of those with latent AIP (P = 0.008) but death from myocardial infarction and stroke was not more common. Uraemia was cited as the cause of death in 9.1% of AIP patients and 1.0% of those without AIP (P = 0.006).Conclusions. Hypertension is more common in patients with manifest AIP than in those with latent AIP or control subjects. Renal disease may be due to hypertension, to AIP or to SLE. AIP may predispose to other renal diseases.
Upper airway obstruction in hypothyroidism
Authors: PELTTARI L. , RAUHALA E. , POLO O. , HYYPPÄ M. T. , KRONHOLM E. , VIIKARI J. , KANTOLA I. 
Published: August 2009

Abstract. Objectives. To determine the occurrence and frequency of nocturnal upper airway obstruction in hypothyroidism.Design. A case‐control study of patients with newly diagnosed hypothyreosis and euthyroid subjects who had been selected from the population register. The subjects underwent sleep recordings with a static‐charge‐sensitive bed (SCSB).Setting. Turku University Hospital and Research and Development Unit, Social Insurance Institution, Turku, Finland.Subjects. Twenty six consecutive patients underwent sleep recordings with SCSB and a pulse oximeter. One hundred and eighty‐eight euthyroid subjects who were previously studied with the SCSB were used as controls.Main outcome measures. In a multivariate analysis, hypothyroidism, gender, age, and body mass index (BMI) were considered as predictors for the occurrence of nocturnal breathing abnormalities.Results. Nocturnal breathing abnormalities were frequent in both groups. Fifty per cent of the hypothyroid patients and 29.3% of the control subjects had at least some episodes of partial or complete upper airway obstruction (P = 0.04). Severe obstruction with episodes of repetitive apnoea was present in 7.7% of the patients and in 1.5% of the controls. The multivariate analysis revealed that the presence of hypothyroidism did not significantly (P = 0.06), and independently of age, BMI or gender, predict nocturnal breathing abnormalities, whereas obesity (P < 0.0001) and male gender (P = 0.0001) were independent and significant predictors.Conclusions. The incidence of nocturnal upper airway obstruction is increased in hypothyroidism, but is related to obesity and male gender rather than to hypothyroidism per se.
Nutritional dose of magnesium in hypertensive patients on beta blockers lowers systolic blood pressure: a double‐blind, cross‐over study
Authors: WIRELL M. P. , WESTER P. O. , STEGMAYR B. G. 
Published: August 2009

Abstract. Objectives. To evaluate if magnesium alters blood pressure in hypertensive patients treated with beta blockers and if such effect can be coupled to a change in potassium and magnesium levels in muscle, serum and urine.Design. A randomized double‐blind, cross‐over study with magnesium and placebo taken orally, each for 8 weeks.Setting. Outpatient clinic, University Hospital, Umeå, Sweden.Subjects. Thirty‐nine patients aged 26–69 years with moderate essential hypertension, treated before entry and during the study with continuous, unchanged beta blockers completed the study.Interventions. Random allocation to receive magnesium aspartate or placebo. Daily magnesium dose was 15 mmol(365 mg) distributed three times a day over 8 weeks.Main outcome measures. Blood pressure, serum, urine and muscle magnesium and potassium. Measurements performed at the start, after 8 and 16 weeks.Results. Systolic supine and standing blood pressure significantly decreased when magnesium was supplemented following placebo but not when magnesium was given at start. When magnesium and placebo groups were independently compared there was no significant change in supine and standing systolic and diastolic pressure. Serum and urine magnesium and serum potassium were significantly higher after magnesium treatment, whilst no change was present in urine potassium or in muscle magnesium and potassium.Conclusions. This study showed that 15 mmol magnesium day‐1 given to mild to moderate hypertensive patients treated with beta blockers could be the cause of a significant decrease in supine and standing systolic blood pressure.
Future challenges to coronary angioplasty: perspectives on intracoronary imaging and physiology
Authors: EMANUELSSON HÅKAN 
Published: August 2009

Abstract. Several intravascular techniques have been developed with the purpose of achieving optimal guidance for treatment during coronary angioplasty (PTCA). Although the coronary angiographic technique is well established, there are still some inherent limitations. Due to intimal rupture, tears, dissection and thrombus following PTCA treatment, angiography does not allow exact delineation of the true borders of the vessel.Coronary angioscopy is currently the most sensitive method to detect coronary thrombus and can also be used to classify atheromatous plaques. Furthermore, coronary dissection can be detected with more accuracy than with angiography. One limitation associated with angioscopy is the need to occlude the vessel during imaging, which may create myocardial ischaemia. Furthermore, there is presently no method for quantifying angioscopic findings.Intravascular ultrasound produces a cross‐sectional image of the vessel, which permits analysis of the layers of the vascular wall. Characterization and classification of various types of plaque can be made, because thrombus, lipid, fibrous tissue and calcium have different ultrasonic echogenicity.Flow velocity measurement with the Doppler technique is an interesting approach to the physiological assessment of coronary stenoses. Coronary flow reserve can be estimated with this method and monitoring of the flow signal following angioplasty will aid in the diagnosis of flow‐limiting complications.The trans‐stenotic pressure gradient is a valuable measure of the haemodynamic importance of a coronary lesion. Trans‐stenotic gradients during maximal hyperaemia obtained with a miniaturized pressure transducer yield reliable information regarding the severity of the stenosis, and the pressure values may be used to calculate the relative coronary flow reserve.In conclusion, all of these intracoronary diagnostic techniques will to some extent play a role in the future of coronary angioplasty. Safety, cost and complexity are some of the factors which will determine the growth potential of each method.
Circulating autoantibodies as serological markers in the differential diagnosis of pulmonary renal syndrome
Authors: SAXENA RAMESH , BYGREN PER , ARVASTSON BERTIL , WIESLANDER JÖRGEN 
Published: August 2009

Abstract. Objectives. Pulmonary renal syndrome (lung haemorrhage and glomerulonephritis) is a fulminant condition that warrants a rapid diagnosis and treatment to prevent mortality and preserve renal functions. However, the patients frequently present with non‐specific pulmonary symptoms in the early phase of the syndrome and the diagnosis is often missed. Recently, several autoantibodies have been described in association with various forms of glomerulonephritis. We evaluated the association as well as the diagnostic and the prognostic significance of these antibodies in pulmonary renal syndrome.Design. Retrospective clinical study.Setting. University Hospital.Subjects. Forty consecutive patients with biopsy verified glomerulonephritis and overt haemoptysis or pulmonary infiltrates compatible with lung haemorrhage.Interventions. Analysis of proteinase 3 antineutrophil cytoplasm antibodies (PR3‐ANCA), myeloperoxidase (MPO)‐ANCA, antiglomerular basement membrane (GBM) and anti‐entactin antibodies.Results. Thirty‐six (90%) patients possessed one or more autoantibodies. Twenty‐seven (70%) patients had ANCA (PR3‐ANCA, MPO‐ANCA or both). The remaining positive patients (n = 9) had anti‐GBM antibodies. Only two patients had anti‐entactin antibodies, suggesting a poor association of these antibodies with PRS. The majority of patients with anti‐GBM antibodies had a very poor clinical outcome (five irreversible renal failure; three deaths). On the other hand, despite no significant difference in clinical features or renal morphology from patients with anti‐GBM antibodies, 19 patients (70%) with ANCA recovered completely following treatment.Conclusions. Our study demonstrated that the presence of autoantibodies is a predominant feature of PRS and that the type of immunologic injury is of paramount importance in determining the course of illness in this syndrome. Analysis of the aforementioned antibodies can help in an early differential diagnosis and thus, in better management of PRS.
Pheochromocytoma in multiple endocrine neoplasia type 2: European study
Authors: Modigliani E. , VASEN H. M. , RAUE K. , DRALLE H. , FRILLING A. , GHERI R. G. , BRANDI M. L. , LIMBERT E. , NIEDERLE B. , FORGAS L. , ROSENBERG‐BOURGIN M. , CALMETTES C. ,   THE EUROMEN STUDY GROUP
Published: August 2009

Abstract. Objectives. Pheochromocytoma (pheo) is the second component of the multiple endocrine neoplasia type 2 (MEN 2) syndrome. Clinical expression is sometimes poor, and chronology between medullary thyroid carcinoma (MTC) and pheo is not well evaluated. Therefore, a retrospective study was done in eight European countries in order to precise the main characteristics of pheo in MEN 2.Subjects. Data from 300 MEN 2 patients with pheo (274 MEN 2 A and 26 MEN 2 B) were obtained from cases registered by the EuroMen study group, and collected by a medical standardized questionnaire. These cases occurred between 1969 and 1992.Results. Mean age at diagnosis of pheo was 39.5 years (range 14–68 years) in MEN 2A and 32.4 years (range 15–41 years) in MEN 2B patients. Pheo occurred first in 25.1% of the cases (2–15 years before diagnosis of MTC) and after MTC in 40.2% (2–11 years). In other cases (34.7%), MTC and pheo were diagnosed at the same time. Involvement was bilateral in 67.8% of cases. Malignancy was only 4%. Thirty‐nine deaths occurred in these 300 patients, 64.1% were linked in pheo, 23.1% to MTC and 12.8% to other causes. Surgery was unilateral in 39.7% of the cases and bilateral adrenalectomy was the first procedure in 48.4%. A bilateral adrenalectomy in two steps had to be done in 11.9% of cases. In conclusion, these results justify systematic and prolonged biochemical screening of pheo during follow‐up of MTC and address some questions about the best mode of surgery.
Objective assessments of allergic and nonallergic rhinitis in young children
Authors: Chawes B. L. K. , Kreiner‐Møller E. , Bisgaard H. 
Published: August 2009

Background:  Allergic and nonallergic rhinitis are common childhood disorders.Objective:  To study nasal eosinophilia and nasal airway patency in young children with allergic and nonallergic rhinitis to assess the pathology behind such diagnoses.Methods:  We investigated 255 children at six years of age from the Copenhagen Prospective Study on Asthma in Childhood birth cohort assessing rhinitis history, specific immunoglobulin E relevant to rhinitis symptoms, nasal eosinophilia and nasal airway patency by acoustic rhinometry before and after decongestion. Associations were studied in a multivariate graphical model corrected for gender, height and nasal steroid usage.Results:  Allergic rhinitis was significantly and directly associated with irreversible nasal airway obstruction (reduced decongested nasal airway patency) (P = 0.004), whereas nonallergic rhinitis was not. Both allergic rhinitis (P = 0.000) and nonallergic rhinitis (P = 0.014) were directly and significantly associated with nasal eosinophilia, but this association was stronger for allergic rhinitis.Conclusion:  Allergic rhinitis and nonallergic rhinitis are of different pathologies as suggested from their different associations not only to allergy but importantly also to irreversible nasal airway obstruction and eosinophilic inflammation. Allergic rhinitis was significantly associated with nasal eosinophilia and irreversible nasal airway obstruction suggesting chronic inflammation and structural remodeling of the nasal mucosa in children at the age of 6 years. Nonallergic rhinitis exhibited no change in the nasal airway patency, but some nasal mucosal eosinophilia albeit less than children with allergic rhinitis.
Corticosteroid elimination in simultaneous liver–kidney transplantation recipients
Authors: Weber Nicholas K. , Wiseman Alexander C. , Trotter James F. 
Published: August 2009

Abstract:  Background:  Simultaneous liver–kidney transplantation (SLK) has more than doubled since 2002. While less common in kidney transplant alone recipients (KTA), corticosteroid discontinuation is performed routinely in liver transplantation, raising the question of optimal immunosuppression for SLK recipients.Methods:  A retrospective case series of 16 SLK recipients under a steroid withdrawal protocol was performed to compare short‐term outcomes to a contemporaneous cohort of 32 KTA recipients.Results:  In 69% of SLK recipients, corticosteroids were eliminated compared to 3% of KTA recipients, p < 0.0001. When comparing SLK and KTA recipients one yr post‐transplant, there were no significant differences in renal graft rejection (23.1% vs. 6.3%), death‐censored renal graft survival (100% vs. 97%), estimated glomerular filtration rate (74.4 vs. 62.6 mL/min), serum creatinine (1.10 vs. 1.39 mg/dL), or maintenance immunosuppression, respectively.Conclusions:  Corticosteroids may be withdrawn safely in SLK recipients with one‐yr renal outcomes comparable to a KTA cohort.
Allergic rhinitis in the child and associated comorbidities
Authors: Sih Tania , Mion Olavo 
Published: August 2009

Sih T, Mion O. Allergic rhinitis in the child and associated comorbidities. Pediatr Allergy Immunol 2010: 21: e107–e113. © 2009 John Wiley & Sons A/SAllergic rhinitis (AR) typically presents after the second year of life, but the exact prevalence in early life is unknown. AR affects 10–30% of the population, with the greatest frequency found in children and adolescents. It appears that the prevalence has increased in the pediatric population. As the childs’ immune system develops between the 1st and 4th yr of life, those with an atopic predisposition begin to express allergic disease with a clear Th2 response to allergen exposure, resulting in symptoms. In pediatric AR, two or more seasons of pollen exposure are generally needed for sensitization, so allergy testing to seasonal allergens (trees, grasses, and weeds) should be conducted after the age of 2 or 3 years. Sensitization to perennial allergens (animals, dust mites, and cockroaches) may manifest several months after exposure. Classification of AR includes measurement of frequency and duration of symptoms. Intermittent AR is defined as symptoms for <4 days/wk or <4 consecutive weeks. Persistent AR is defined as occurring for more than 4 days/wk and more than 4 consecutive weeks. AR is associated with impairments in quality of life, sleep disorders, emotional problems, and impairment in activities such as work and school productivity and social functioning. AR can also be graded in severity – either mild or moderate/severe. There are comorbidities associated with AR. The chronic effects of the inflammatory process affect lungs, ears, growth, and others. AR can induce medical complications, learning problems and sleep‐related complaints, such as obstructive sleep apnea syndrome and chronic and acute sinusitis, acute otitis media, serous otitis media, and aggravation of adenoidal hypertrophy and asthma.
Bipolar II disorder: arguments for and against a distinct diagnostic entity
Authors: Vieta Eduard , Suppes Trisha 
Published: August 2009

Objective:  As a commitment to the International Society for Bipolar Disorders (ISBD), a Task Force was developed to investigate the diagnostic value of bipolar II disorder.Methods:  Task Force members worked jointly reviewing all relevant literature (original articles, reviews, letters, book chapters and congress presentations) that included ‘bipolar II disorder’ and/or ‘hypomania’ as key words.Results:  Bipolar II disorder appears to be a reasonably valid and reliable diagnostic category yet often underdiagnosed or misdiagnosed as unipolar disorder or personality disorder. Moreover, it is officially recognized as a mental disorder in DSM‐IV‐TR but not in ICD‐10, and many clinicians still regard it as a milder form of manic‐depressive illness, despite data supporting high morbidity and mortality rates. In fact, bipolar II may be the most prevalent bipolar phenotype, although current diagnostic boundaries are seen as quite restrictive concerning the required duration for hypomania (4 days), the exclusion of hypomanic episodes potentially triggered by antidepressants and other substances, and the negligence of hypomanic mixed states. The course of bipolar II disorder is characterized by depressive predominant polarity, and its treatment is still controversial and poorly evidence‐based.Conclusions:  Bipolar II disorder is supported as a distinct category within mood disorders, but the definition and boundaries deserve a greater clarification in the DSM‐V and ICD‐11.