bluuebunny/crossref_metadata_2025_split huggingface dataset:
Streptokinase, but not tissue plasminogen activator, attenuates platelet aggregation in patients with acute myocardial infarction
Authors: KARLBERG K.‐E. , CHEN J. , HAGERMAN I. , BERGSTRÖM K. , WALLIN R. , SALDEEN T. , SYLVÉN C. 
Published: August 2009

Abstract. Objectives. To investigate if tissue plasminogen activator (tPA) and streptokinase given during acute myocardial infarction (AMI) have different effects on platelet aggregation which could contribute to the higher reocclusion rate observed after tPA.Design. Open labelled on consecutive patients.Setting. Coronary care unit.Subjects. Twenty patients with chest pain and ST elevations on an electrocardiogram suggestive of AMI.Interventions. Ten patients were treated with tPA (100 mg 3 h−1), 10 patients with streptokinase (1.5 × 106 IU 1 h−1).Main outcome measures. Before, immediately after and 24 h after fibrinolytic therapy, platelet aggregation was estimated with filtragometry and whole blood aggregometry. Fibrinogen, β‐thromboglobulin, elastase and the fibrinogen‐derived peptide Bβ 30–43 were also measured.Results. The groups were comparable at baseline. Directly after treatment, streptokinase prolonged aggregation time in filtragometry with 112 ± 140 s (P < 0.03) and reduced conductance in whole blood aggregometry by 6.2 ± 6.1 Ω (P < 0.03), both tests indicating inhibited platelet function. Fibrinogen decreased 2.5 ± 1.0 g l−1 (P < 0.02). In the tPA‐treated group corresponding changes were 68 ± 225s (NS) and 2.5 ± 7 Ω (NS) with no significant reduction in fibrinogen. After 24 h, at which time every patient was on acetylsalicylic acid, aggregation was inhibited in both groups as measured by aggregometry. Directly after fibrinolytic treatment, neutrophils were similarly activated in both groups with increments of elastase and Bβ 30–43 by 26 ± 46 μg l−1 (P < 0.03) and 280 ± 381 pmol l−1 (P < 0.03) respectively (streptokinase) and by 12 ± 6 μg l−1 (P < 0.02) and 919 ± 856 pmol l−1 (P < 0.02) respectively (tPA).Conclusions. Despite similar degrees of platelet and leucocyte activation, streptokinase but not tPA treatment appears to inhibit platelet aggregation. One possible reason could be a streptokinase‐induced pronounced decrease of fibrinogen and increase of fibrinogen split products. Therefore, further development of adjuvant antiplatelet therapy could be of clinical importance.
High frequency of antibodies to Hantaan virus and hepatitis C virus in chronic haemodialysis patients Coincidence or cross‐reaction?
Authors: TSIANOS E. V. , DALEKOS G. N. , ELISAF M. , ZERVOU E. , Siamopoulos K. C. 
Published: August 2009

Abstract. Objectives. To address the question of whether there is any coincidence or cross‐reaction between hepatitis C virus (HCV) and Hantaan virus (both RNA arboviruses), as well as to assess the frequency of antibodies to the above viruses amongst chronic haemodialysis patients in our region.Design. Collection of serum samples from consecutive unselected chronic haemodialysis patients.Setting. A tertiary referral center (University Hospital).Subjects. One hundred and fourteen chronic haemodialysis patients were investigated for the presence of antibodies to HCV (anti‐HCV) and Hantaan virus disease (anti‐HVD). Eleven unselected non‐haemodialysis patients with well‐defined haemorrhagic fever with renal syndrome (HFRS) were also investigated for the anti‐HCV antibodies comprising the disease control group.Interventions. None.Main outcome measures. The utility of an anti‐HVD positive test in chronic haemodialysis patients.Results. Seventeen patients (14.9% 95% confidence interval [CI] 8.4–21.4%) were anti‐HCV positive, whereas 15 (13.2%, 95% CI 6.9–19.3%) were anti‐HVD positive. An anti‐HCV positive test was confirmed by recombinant immunoblot assay (RIBA II) in 88.2%. The presence of anti‐HCV antibodies was not associated with transfusions but with the longer duration of haemodialysis (62.8 ± 29.8 vs. 31.2 ± 29.3 months, P < 0.001). Anti‐HVD antibodies were not associated with transfusions or with the duration of haemodialysis. Three patients were positive for both anti‐HCV and anti‐HVD antibodies. None of the 11 patients with well‐defined HFRS had anti‐HCV antibodies.Conclusions. Chronic haemodialysis patients are a high risk group for HCV infection in association with the duration of haemodialysis and, at least for our geographical area, these patients have to be examined for anti‐HVD antibodies especially when a definite causative agent for chronic renal failure is not found. The HVD and HCV infection are not exceptional amongst haemodialysis patients in our region, whereas the possibility of a cross‐reaction between these two RNA arboviruses is rather excluded as there was no evidence of HCV infection amongst the patients with well‐defined HFRS.
Blood pressure, physical fitness and physical activity in 17‐year‐old Danish adolescents
Authors: ANDERSEN L. B. 
Published: August 2009

Abstract. Objective. To test the relationship between physical activity and physical fitness, and the relationship between these variables and the primordial risk factor blood pressure (BP).Design. A cross‐sectional study of all Danish pupils in the same grade at ‘gymnasium’ (the Danish upper secondary school).Setting. Tests and questionnaires were administered by physical education and biology teachers according to a prescribed scheme.Subjects. Study subjects were 13810 adolescents with a mean age of 17.1 years. Physical activity, smoking habits, and physical performance were measured in 4862 boys and 6573 girls. Blood pressure was measured in 2474 boys and 3535 girls. No difference was found in BP, physical activity and fitness variables between this group and a representative group of Danish school children at the same age.Main outcome. Blood pressure and health‐related physical performance such as strength, muscle endurance, flexibility and maximal oxygen uptake (VO2max) estimated from heart rate at submaximal workload were measured. Sports activity, other physical activity and smoking habits were assessed by questionnaires.Results. There was a negative relationship between BP and VO2max up to the 50% percentile (50 ml min−1 kg−1) in boys and up to the upper 80–90% percentile (45 ml min−1 kg−1) in girls. In a multiple regression model with BP as dependent variable, VO2max related highly significant, also after adjustment for body weight and physical activity (P < 0.001). Other performance variables only explained a small part of the variance in BP. No relationship was found between BP and total physical activity or sports activity.Conclusion. In the adolescent population VO2max related negatively to BP after adjustment for body weight, physical activity, other fitness measures and sex, but physical activity or other fitness measures did not relate. Lower blood pressure was found with higher VO2max until levels of 50 and 45 ml min−1 kg−1 in boys and girls, respectively.
Standardized radioiodine therapy in Graves' disease: the persistent effect of thyroid weight and radioiodine uptake on outcome
Authors: de BRUIN T. W. A. , CROON C. D. L. , de KLERK J. M. H. , VAN ISSELT J. W. 
Published: August 2009

Abstract. Objective. To assess the incidence of hypothyroidism, euthyroidism, and recurrent hyperthyroidism following a standard dose of Na131I (3.7 MBq or 100 μCi) per g thyroid tissue, adjusted for radioiodine tracer uptake.Design. A single‐centre prospective follow‐up study from January 1990 to December 1992.Setting. Academic Hospital in Utrecht, the Netherlands.Subjects. Newly diagnosed patients with Graves' disease (n = 148).Interventions. Radioiodine treatment at a standard dose of 3.7 MBq or 100 μCi per g thyroid tissue.Main outcome measures. Confidence interval testing of resulting thyroid status, defined by biochemical criteria.Results. The overall cure rate was 70% (103 of 148 subjects), confidence interval (CI) 62–77%. A 90% incidence of hypothyroidism was found in patients with a small thyroid (less than 20 g). Recurrent hyperthyroidism was found significantly more often in subjects with a thyroid weight exceeding 60 g compared to those who had a thyroid of 9–59 g. More recurrences were found in subjects in the highest tertile of a 24‐h radioiodine uptake test (> 80% uptake) compared to those in the lowest tertile (< 60% uptake).Conclusions. No uniform treatment results expressed per thyroid weight category were obtained, in spite of standardizing the treatment Na131I dose (3.7 MBq per g thyroid). Graves' patients with a thyroid smaller than 20 g and those with less than 60% 24‐h radioiodine uptake have a 50–90% chance of hypothyroidism at the 12‐month follow‐up.
Fever of unknown origin in HIV‐infected patients: a critical analysis of a retrospective series of 57 cases
Authors: BISSUEL F. , LEPORT C. , PERRONNE C. , LONGUET P. , VILDE J.‐L. 
Published: August 2009

Abstract. Objectives. The aim of the study was to assess the incidence and aetiology of fever of unknown origin in human immunodeficiency virus (HIV)‐infected patients, and to evaluate the usefulness of the main diagnostic procedures.Design. A retrospective study.Setting and subjects. We reviewed the records of 270 HIV‐infected patients who were hospitalized for the first time in a department of infectious and tropical diseases during the 27 month study period.Main outcome measures. Fifty‐seven patients (21 %) had a history of fever of unknown origin.Results. The aetiology was found in 49 cases (86 %). The major cause of the fever was mycobacteriosis: atypical mycobacteria in 10 cases, Mycobacterium tuberculosis in 10, mycobacteria of unspecified type in two, and BCG strain in one. A liver biopsy and a thoracic CT scan greatly contributed to the diagnosis of mycobacterial infection. Seventeen patients were given empiric antimycobacterial therapy as a therapeutic test, of whom seven had a favourable response. The other main causes of fever were cytomegalovirus infection in five patients, leishmaniasis in four, and lymphoma in four.Conclusions. Fever of unknown origin is a frequent occurrence in the course of HIV infection, and mycobacterial infection should be considered as a first‐line diagnosis in such cases. The place of empiric antimycobacterial therapy in the diagnostic strategy requires further evaluation, but appears to be an alternative to multiple investigative procedures.
The occurrence of polyglandular autoimmune syndrome type III associated with coeliac disease in patients with sarcoidosis
Authors: PAPADOPOULOS K. I. , HÖRNBLAD Y. , HALLENGREN B. 
Published: August 2009

Abstract. Objectives. To study whether an association between polyglandular autoimmune (PGA) syndrome type III [including autoimmune thyroid disease (ATD) and insulin‐dependent diabetes mellitus (IDDM)], coeliac disease and sarcoidosis, exists.Design. In patients with documented sarcoidosis, the presence of the disease constellation of ATD, IDDM and coeliac disease was examined.Setting. The patients were recruited at the Department of Pulmonary Medicine, and the study was conducted at the Department of Endocrinology, Lund University Clinics, General Hospital, Malmö, Sweden.Subjects. Of all patients (n = 89) with documented sarcoidosis attending the Department of Pulmonary Medicine between January 1980 and December 1991, 78 patients (44 males, 34 females; median age at the time of the study 48 years, range 22–81 years; median observation time since the diagnosis of sarcoidosis 120 months, range 1–468 months) were examined in the present study.Results. Amongst the 78 patients with documented sarcoidosis, one female patient was found with PGA syndrome type III, coeliac disease and sarcoidosis.Conclusions. This present patient further indicates the existence of an association between polyglandular autoimmune (PGA) syndrome type III, coeliac disease and sarcoidosis. To determine whether this disease constellation might constitute a new syndrome, further studies on larger groups of patients with sarcoidosis are demanded.
A case of central diabetes insipidus with spontaneous remission after 8 years of the disease
Authors: Nagae A. , Kohara K. , Iwata T. , Okura T. , Ohtsuka T. , Kukita H. , Hrwada K. 
Published: August 2009

Abstract. A 55‐year‐old male smoker developed polyuria and polydipsia in November 1983. A water deprivation study revealed a defect in the urine concentrating function, which was corrected by vasopressin. Plasma antidiuretic hormone (ADH) was not increased by smoking. His condition was well controlled by deamino‐d‐arginine vasopressin. However, since February 1992 he has become completely free from the need for medication to control his urine volume. Re‐evaluation studies with water deprivation and smoking revealed dramatic improvements in the urine concentrating function and ADH response.A patient with idiopathic diabetes insipidus with spontaneous remission after 8 years is reported.
Overtreatment and undertreatment of hypertension
Authors: Furberg C. D. , Berglund G. , Manolio T. A. , Psaty B. M. 
Published: August 2009

Abstract. Furberg CD, Berglund G. Manolio TA, Psaty BM (Department of Public Health Sciences, Bowman Gray School of Medicine, Winston‐Salem, NC, Epidemiology and Biometry Program, Division of Epidemiology and Clinical Applications. National Heart, Lung and Blood Institute, Bethesda, MD, Department of Medicine, Epidemiology and Health Services, University of Washington, Seattle. WA, USA; Department of Medicine, Lund University, Malmo, Sweden). Overtreatment and undertreatment of hypertension (Frontiers in medicine). Journal of Internal Medicine 1994; 235: 387–397.Results from a large number of randomized clinical trials document conclusively that treatment of elevated systolic and/or diastolic blood pressure markedly reduces the risk of cardiovascular complications such as stroke and acute myocardial infarction. Detection, treatment and control of hypertension have major public health implications. A review of the literature suggests the existence of both overtreatment (defined as improper or incorrect diagnosis of hypertension, overaggressive and potentially dangerous blood pressure lowering and the use of expensive antihypertensive drugs with unproven mortality/morbidity benefits) and undertreatment (defined as unrecognized, untreated and poorly controlled hypertension). These current major issues in medicine are discussed.
von Willebrand factor and fibrinolytic variables are differently affected in the insulin resistance syndrome
Authors: NILSSON T. K. , BOMAN K. , BJERLE P. , HALLMANS G. , HELLSTEN G. 
Published: August 2009

Abstract. Objectives. To test whether von Willebrand factor, a new cardiovascular risk factor, belongs to the group of risk factors forming part of the insulin resistance syndrome.Design. A population‐based, age‐stratified, cross‐sectional study.Setting. A primary health care centre.Subjects. All subjects aged 35, 45, 55, and 65 years in Norsjö municipality (n = 265) were invited, and 68% (82 males, 93 females) entered and completed the study.Results. von Willebrand factor did not correlate with any measured lipid, anthropometric, or glucose metabolism variable. The higher levels of cardiovascular risk factors found in the subgroup of patients with electrocardiographical signs of ischaemic heart disease did not confound this result.Conclusion. von Willebrand factor plasma concentration is unrelated to the metabolic factors involved in the insulin resistance syndrome. Thus, it may be difficult to reduce elevated von Willebrand factor levels by conventional non‐pharmacological cardiovascular high‐risk intervention schemes.
The personality patterns in patients with duodenal ulcer and ulcer‐like dyspepsia and their relationship to the course of the diseases
Authors: JESS P. , ELDRUP J. ,   Hvidovre Ulcer Project Group
Published: August 2009

Abstract. Objectives. To compare personality characteristics in duodenal ulcer patients and patients with ulcer‐like dyspepsia from the primary health sector with duodenal ulcer patients from a hospital and to evaluate the relationship of the personality characteristics to the course of the diseases.Design. A prospective study using the Minnesota Multiphasic Personality Inventory (MMPI) with retesting of a subgroup of patients after a median observation period of 14 months.Setting. Departments of Medical and Surgical Gastroenterology, Hvidovre University Hospital, and the primary health sector in Roskilde County, Denmark.Subjects. Sixty hospital patients with duodenal ulceration and 17 patients with duodenal ulceration plus 2 5 patients with ulcer‐like dyspepsia from the primary health sector.Main outcome measures. MMPI scores.Results. The hospital patients differed from the two other groups of patients by having higher scores of depression and anxiety (P < 0.05). Twenty‐eight of the patients were retested with MMPI. Contrary to the patients with persisting complaints, abnormal personality characteristics disappeared in patients without complaints (P < 0.05‐0.001).Conclusions. The results indicate that abnormal personality characteristics in patients with functional and organic upper dyspepsia are consequential rather than causal factors.
Deaths from pulmonary tuberculosis in a low‐incidence country
Authors: NAALSUND A. , HELDAL E. , JOHANSEN B. , KONGERUD J. , BOE J. 
Published: August 2009

Abstract. Objectives. To study the validity of official mortality statistics regarding deaths from pulmonary tuberculosis, and to identify factors contributing to death.Design. A retrospective study.Setting. Cases were enrolled from the data of the Central Bureau of Statistics from where the official mortality statistics are issued, the National Tuberculosis Register and all Autopsy Registers in the region.Subjects. Case and autopsy reports from all patients who died from active pulmonary tuberculosis in two Norwegian counties between 1977 and 1989.Main outcome measures. Patients identified from all three registers with active pulmonary tuberculosis, concomitant diseases/risk‐factors, chest X‐rays, symptoms, number of patients investigated and treated for tuberculosis, duration from hospital admission until start of treatment and/or death.Results. Ninety‐six patients, median age 75 years, died from pulmonary tuberculosis, 51 without treatment. Thirty‐four patients had not been registered at the Central Bureau of Statistics. Thirty‐nine patients had cough on admission. Weight loss and generalized malaise occurred just as frequently. Forty‐two patients had infiltrates on chest X‐ray located elsewhere than in the apical region. In 42 patients, no diagnostic tests for tuberculosis were performed. The median length of stay in hospital was 24 days before death in the untreated group, and 21 days before start of treatment in the treated group.Conclusion. Reliable figures of patients who died from pulmonary tuberculosis could not be obtained from the official statistics because of under‐notification and erroneous codification of diseases. Deaths occurred mainly because the diagnosis was established too late: in half of the patients at autopsy. Eighty‐one patients had concomitant diseases known to lower resistance against tuberculosis. Lack of diagnostic suspicion may have been caused by nonspecific symptoms and atypical chest X‐ray findings.
Direct effect of insulin on 45calcium uptake in human erythrocytes
Authors: PETTERSSON L. , FRITHZ G. , RONQUIST G. 
Published: August 2009

Abstract. Objective. High blood pressure is prevalent in obesity and non‐insulin dependent diabetes mellitus: both conditions, with insulin resistance and essential hypertension, have been associated with increasing intra‐erythrocytic levels of calcium ions. We tested the hypothesis of whether insulin itself might be responsible for the abnormal red cell cytosolic free calcium.Design. The ionic effects of insulin were studied on the kinetics of 45calcium uptake in vitro in normal human erythrocytes.Setting. The study was performed in the outpatient clinic of a central hospital.Subjects. Sixteen healthy, normotensive individuals with normal body mass index were recruited for the study.Main outcome measures. Blood from eight individuals was used for time‐dependent studies of 45calcium uptake in erythrocytes and blood from another eight individuals was used for dose‐dependent studies of insulin effect.Results. The rate of 45calcium influx in red blood cells has two components, a fast component (0–10 min), which measures the initial rate of 45calcium influx, and a slow component (10–60 min) probably reflecting a relatively large backflux of calcium (calcium efflux), which accordingly determines an apparent low rate of 45calcium influx between 10–60 min. The uptake was linear with time between 10–120 min regardless of insulin being present or not. Insulin at a concentration of 120 mUL‐1 significantly decreased the 45calcium uptake in a timedependent fashion between 10–120 min. The uptake was 508 (±59) at 60 min in the presence of insulin vs. a control value of 529 (±59) pmol mL red blood cells‐1 (P < 0.001). The corresponding figures at 120 min were 742 (±log) and 767 (±127), respectively (P = 0.02). Inconsistent results were obtained on 45calcium uptake at 60 min by varying insulin concentrations from 40–640 mUL‐1 and a dual effect of insulin on 45calcium uptake could not be excluded, one at a fairly low concentration of insulin (40–120 mUL‐1) and another at a high concentration (160–640 mUL‐1).Conclusion. The data indicate a direct role of insulin in the transport process of calcium into normal human erythrocytes.
Serum sialic acid concentration is elevated in IDDM especially in early diabetic nephropathy
Authors: YOKOYAMA HIROKI , JENSEN JAN S. , JENSEN TONNY , DECKERT TORSTEN 
Published: August 2009

Abstract. Objectives. Elevated serum sialic acid concentration is a strong predictor of cardiovascular mortality in non‐diabetic subjects. Because patients with insulin‐dependent diabetes mellitus (IDDM) and albuminuria have a highly increased cardiovascular morbidity and mortality, we hypothesized that IDDM patients with albuminuria would have an increased concentration of serum sialic acid.Design. Cross‐sectional study.Setting. Outpatient clinic at Steno Diabetes Centre, Gentofte, Denmark.Subjects. Twenty‐six non‐diabetic controls and 74 IDDM patients with normoalbuminuria (urinary albumin excretion [UAE] < 30 mg 24 h−1; n = 37), incipient nephropathy (UAE 30–300 mg 24 h−1; n = 20) and clinical nephropathy (UAE > 300 mg 24 h−1; n = 17), matched for sex, age and body mass index (BMI).Main outcome measures. Serum sialic acid concentration, concurrent fasting blood glucose, glycated haemoglobin (HbA1c), serum creatinine, plasma fibrinogen and erythrocyte sedimentation rate.Results. Normoalbuminuric patients had a higher serum sialic acid concentration (mmol L−1) than non‐diabetic controls (1.83 ± 0.24 vs. 1.67 ± 0.26; P < 0.02). Serum sialic acid concentration was further increased in patients with incipient nephropathy (2.02 ± 0.37; P < 0.03) and in patients with clinical nephropathy (2.13 ± 0.33; P < 0.002) compared with normoalbuminuric IDDM patients. Serum sialic acid correlated strongly with plasma fibrinogen (r = 0.78; P < 0.0001) and erythrocyte sedimentation rate (r = 0.62; P < 0.0001). In a multiple regression analysis including UAE, retinopathy status, fasting blood glucose, HbA1c, mean blood pressure, serum creatinine, age, BMI, duration and smoking, UAE and fasting blood glucose were the independent variables which correlated significantly with serum sialic acid concentration (P < 0.0001 and P < 0.05, respectively).Conclusion. Serum sialic acid is elevated in IDDM especially in albuminuric patients. Whether elevated serum sialic acid is predictive for early diabetic nephropathy and cardiovascular disease in IDDM has to be shown in the future.