bluuebunny/crossref_metadata_2025_split huggingface dataset:
The response to inhaled and oral steroids in patients with stable chronic obstructive pulmonary disease
Authors: Weiner P. , Weiner M. , Rabner M. , Waizman J. , Magadle R. , Zamir D. 
Published: March 2003

Abstract.Background. A significant minority of patients with COPD have favourable response to corticosteroid treatment. In addition, the benefit of corticosteroid treatment may be outweighed by the side‐effects. Long‐term administration of inhaled steroids is a safe means of treatment. However, only a few studies have addressed the role of inhaled steroids in patients with COPD, with conflicting results.Methods. Forty‐four patients with stable COPD were defined as ‘responders to bronchodilators’ (increase in FEV1 > 20% following administration of β2‐agonist) (group A), and 124 as ‘non‐responders to bronchodilators’ (group B). All patients were randomized to receive a 6‐week course of either a daily dose of 800 μg of inhaled budesonide or placebo, separated by 4 weeks when no medication was taken; were randomized again to receive a 6‐week course of either 1600 μg day−1 of inhaled budesonide, or 800 μg day−1 of inhaled budesonide plus placebo; and were randomized once again to receive a 6‐week course of either 40 mg day−1 of prednisone or placebo. All stages were performed in a double‐blind cross‐over design.Results. Following administration of 800 μg day−1 of inhaled budesonide, there was an increase in the mean FEV1 from 1.40 ± 0.20 to 1.92 ± 0.22 L (P < 0.001) and a significant decrease in inhaled β2 agonist consumption in group A. These changes remained almost stable during the increased dose of inhaled budesonide or during prednisone treatment. The mean FEV1 did not change during the placebo period, or in group B in either treatments.Conclusions. Treatment with inhaled steroids improved spirometry data and inhaled β2‐agonist consumption in about one‐quarter of patients with stable COPD, and this rate increased to about three‐quarters in patients who responded to β2‐agonist inhalation. There was no additional benefit in using a higher dose of inhaled budesonide or prednisone.
The survival and well‐being of patients treated for Cushing’s syndrome
Authors: Pikkarainen L. , Sane T. , Reunanen A. 
Published: March 2003

Abstract. Pikkarainen L, Sane T, Reunanen A (Helsinki University Hospital and National Public Health Institute, Helsinki, Finland). The survival and well‐being of patients treated for Cushing’s syndrome. J. Intern Med 1999; 245: 463–468.Objective.  The main aim of the study was to evaluate the survival, well‐being and working capacity of patients treated for Cushing’s syndrome.Design.  The study was carried out by retrospectively analysing patient records from years 1981–94. Follow‐up time was extended from the time of diagnosis to the end of 1996. A questionnaire dealing with symptoms prior to and after therapy, and the quality of life estimated on a Visual Analogue Scale (VAS) was sent to all surviving patients.Setting.  The study was performed in a university hospital.Main outcome measures.  Survival, subjective well‐being, working capacity before and after treatment and disappearance of symptoms after treatment of Cushing’s syndrome.Results.  During the follow‐up time 10 patients died out of a total of 74. The overall standardized mortality ratio (SMR) was 168% (95% CI 81–309%). The SMR of patients with pituitary disease was 267% (89–525%), and in patients with adrenal adenoma it was 135% (16–489%). Forty‐six per cent of the surviving patients stated that they felt fully recovered from the disease, but the proportion of patients having persisting symptoms after treatment was also noteworthy. The mean VAS score (range 0–100) was 19 (SD 14) before treatment and 82 (SD 18) after treatment (P < 0.001). After treatment, 81% of the patients were able to return to work, 11% retired because of disability, 5% retired because of age and 3% were on sick‐leave at the time of answering the questionnaire. During the follow‐up time, 42% of the patients with pituitary disease suffered a relapse. However, the effect of the relapse on well‐being was not significant.Conclusions.  The mortality risk of patients treated for Cushing’s disease was not significantly increased compared with that of the general population. Many symptoms persisted even years after therapy. After clinical recovery, working ability was not always regained.
Normohomocysteinaemia and vitamin‐treated hyperhomocysteinaemia are associated with similar risks of cardiovascular events in patients with premature peripheral arterial occlusive disease. A prospective cohort study
Authors: De Jong S. C. , Stehouwer C. D. A. , Van Den Berg M. , Geurts T. W. , Bouter L. M. , Rauwerda J. A. 
Published: March 2003

Objectives. Mild hyperhomocysteinaemia (HHC), fasting or after methionine loading, is associated with an increased risk and severity of atherosclerotic vascular disease. Post‐methionine and fasting HHC are responsive to treatment with vitamin B6 and folic acid. We performed a prospective cohort study amongst normohomocysteinaemic and vitamin‐treated (vitamin B6, 250 mg plus folic acid, 5 mg daily) hyperhomocysteinaemic patients with premature peripheral arterial occlusive disease and assessed the incidence of cardiovascular events.Design. We studied 273 consecutive patients with clinically manifest peripheral arterial occlusive disease with onset before the age of 56, 79 (28.9%) of whom had postmethionine HHC. Follow‐up was obtained in 232 (85%) patients. At baseline, 70 (30%) were hyperhomocysteinaemic after methionine loading and started treatment with vitamin B6 and folic acid; 162 (70%) were normohomocysteinaemic (reference group).Results. During the follow‐up period (median 20, range 1–63 months), 48 (29.6%) and 23 (32.9%) of the normo‐ and the hyperhomocysteinaemic patients, respectively, had a new cardiovascular event. Most (75%) involved the peripheral arterial system. The crude incidence rate for any cardiovascular event was 0.16 (95% CI, 0.12–0.21) per person per year in the normohomocysteinaemic and 0.16 (95% CI, 0.09–0.22) per person per year in the hyperhomocysteinaemic group.Multivariate Cox regression analyses showed that higher plasma homocysteine levels were associated with an increased risk of new cardiovascular events in the normohomocysteinaemic patients (relative risk [RR] per 1 µmol L–1, 1.17 [CI, 1.05–1.30] for fasting and 1.06 [CI, 1.01–1.12] for postmethionine levels), but not in the hyperhomocysteinaemic (vitamin‐treated) patients. The adjusted RR for new cardiovascular events in the hyper‐ as compared to the normohomocysteinaemic patients was 0.76 (CI, 0.33–1.74).Conclusions. These data are consistent with a protective effect of treatment with vitamin B6 and folic acid in patients with premature peripheral arterial occlusive disease and postmethionine HHC. Double‐blind randomized trials are necessary to confirm this.
Meal pattern and risk factor evaluation in one‐year completers of a weight reduction program for obese men – the ‘Gustaf’ study
Authors: Andersson I. , Lennernäs M. , Rössner S. 
Published: March 2003

Abstract Andersson I, Lennernäs M, Rössner S (Huddinge University Hospital, Huddinge; and Swedish Dairy Association, Stockholm, Sweden). Meal pattern and risk factor evaluation in one‐year completers of a weight reduction program for obese men – the ‘Gustaf’ study. J Intern Med 2000; 247: 30–38.Objectives To evaluate changes in meal patterns and in obesity related risk factors after 1 year of treatment in obese men.Design Data from two 24‐h dietary recalls, performed at base‐line and after 1 year of treatment, were related to changes in medical risk factors.Setting Academic obesity unit.Subjects Sixty‐three men, aged 44 (eight) years (mean [SD]) and Base‐line Body Mass Index (BMI) 37.4 (4.6) kg m–2, who had completed 1 year of treatment. The men were subdivided by tertiles according to weight change: tertile I (n = 21), mean +0.3 kg, tertile II (n = 21), mean –5.8 kg and tertile III (n = 21), mean –14.2 kg.Main outcome measures Weight loss, changes in meal patterns and in obesity related medical risk factors.Results The reported mean energy intake decreased after treatment in tertiles II and III by 700 (1300) kcal (P < 0.05) and 700 (900) kcal (P = 0.001), respectively. In tertile III the energy‐% from fat decreased (P < 0.05) with a reciprocal increase in energy‐% from protein (P < 0.05). The frequency of snacks of a low nutritional quality decreased (P < 0.01) in tertile III together with an increase in energy‐% from ‘hot meals of good quality’ (P < 0.05). Obesity related risk factors (anthropometry, blood pressure, serum lipid concentrations, blood glucose and plasma insulin) improved in a beneficial way only in tertile III.Conclusions The weight loss in the successful tertile III men was to a great extent explained by fewer low quality snacks but more energy from high quality meals. These changes reflected the behaviour modification strategy recommended.
Prevalence of carotid artery kinking in 590 consecutive subjects evaluated by Echocolordoppler. Is there a correlation with arterial hypertension?
Authors: Pancera P. , Ribul M. , Presciuttini B. , Lechi A. 
Published: March 2003

Abstract.Pancera P, Ribul R, Presciuttini B, Lechi A (Università di Verona, Italy). Prevalence of carotid artery kinking in 590 consecutive subjects evaluated by Echocolordoppler. Is there a correlation with arterial hypertension?J Intern Med2000;248:7–12.Objective.To assess a possible correlation between high blood pressure and prevalence of kinking in carotid arteries.Design.Between July 1, 1997 and December 31, 1998, we evaluated the subjects submitted to Echocolordoppler examination of carotid arteries.Setting.Patients were examined at the Laboratory for Noninvasive Vascular Diagnostics of the University Hospital in Verona.Subjects.&590 consecutive subjects (M/F ratio, 1/1.2; mean age, 67 years; range, 36–86 years).Main outcome measures.An Echocolordoppler ultrasonograph to evaluate by means of the standard longitudinal and transverse scans the usual parameters of both intima‐to‐lumen interface and flow. Moreover, particular attention was paid to the analysis of the conformational characteristic of the vessels. Kinking has been classified in three classes according to the degree of bending. All the subjects were asked to compile a questionnaire that provided us with the clinical history.Results.The prevalence of hypertension in the subjects with kinking appeared higher than in subjects without this abnormality (χ2 = 6.44,P < 0.02). We found also a significant association between kinking and transitory ischaemic attacks (χ2 = 6.987,P < 0.01).Conclusions.The high prevalence of kinking in the hypertensives agrees with the pathogenetical hypothesis ascribing a role to the high endoluminal pressure. The presence of hypertension and kinking of the internal carotid artery suggests that they could be additive risk factors in the pathophysiology of a transitory ischaemic attack.
Mortality, risk indicators of death, mode of death and symptoms of angina pectoris during 5 years after coronary artery bypass grafting in men and women
Authors: Herlitz J. , Brandrup‐Wognsen G. , Karlson B. W. , Sjöland H. , Karlsson T. , Caidahl K. , Hartford M. , Haglid M. 
Published: March 2003

Abstract. Herlitz J, Brandrup‐Wognsen G, Karlson BW, Sjöland H, Karlsson T, Caidahl K, Hartford M, Haglid M (Sahlgrenska University Hospital, Göteborg, Sweden). Mortality, risk indicators of death, mode of death and symptoms of angina pectoris during 5 years after coronary artery bypass grafting in men and women. J Intern Med 2000; 247: 500–506.Aim. To describe mortality, risk indicators of death, mode of death and symptoms of angina pectoris during 5 years after coronary artery bypass grafting in women and men.Sample. All patients in western Sweden who underwent coronary artery bypass grafting without concomitant valve surgery and without previously performed coronary artery bypass grafting between June 1988 and June 1991.Results. In all, 2000 patients participated in the evaluation, 381 (19%) of whom were women. Compared to men, who had a 5‐year mortality of 13.3%, women had a relative risk of death of 1.4 (95% CI 1.0–1.8; P = 0.03). Renal dysfunction interacted significantly (P = 0.048) with gender, in that the differences were more marked in patients without renal dysfunction. When adjusting for differences at baseline, the relative risk of death amongst women was 1.0 (95% CL 0.7–1.3). Compared to men, women had an increased risk of in‐hospital death and death associated with stroke. However, amongst the patients who died, the place and mode of death appeared to be similar in women and men. Amongst survivors after 5 years, women had more symptoms of angina pectoris than men.Conclusion. During 5 years after coronary artery bypass grafting, women had an increased mortality compared to men; renal dysfunction seemed to interact with female gender regarding mortality. Women had a higher risk of in‐hospital death and death associated with stroke. However, the adjusted relative risk of death during 5 years was equal in women and men. Amongst survivors, women suffered more from angina pectoris than men.
Immunomodulation of atherosclerosis: myth and reality
Authors: Nicoletti A. , Caligiuri G. , Hansson G. K. 
Published: March 2003

Abstract. Nicoletti A, Caligiuri G & Hansson GK (Hôpital Broussais, Paris, and Karolinska Institute, Stockholm). Immunomodulation of atherosclerosis: myth and reality (Minisymposium). J Intern Med 2000; 247: 397–405.Atherosclerosis is an inflammatory disease which displays features of immune activation both locally and systemically. In the present review, we discuss the evidence for immune activation in human disease and experimental models, and survey candidate antigens associated with atherosclerosis. Studies of atherosclerosis in genetic models of immunodeficiency are analysed, as well as immunomodulating therapies and immunization protocols. Based on recent research, it is concluded that immunomodulation represents an interesting approach to the development of new prevention and treatment methods for atherosclerosis.
Multiple endocrine neoplasia type 2 syndromes may be associated with renal malformations
Authors: Loré F. , Talidis F. , Di Cairano G. , Renieri A. 
Published: March 2003

Loré F, Talidis F, Di Cairano G, Renieri A (Endocrinology Unit; Medical Genetics Unit, University of Siena, Italy). Multiple endocrine neoplasia type 2 syndromes may be associated with renal malformations.J Intern Med2001;250:37–42.Objective. TheRETproto‐oncogene is known to be the susceptibility gene for various disease phenotypes, including multiple endocrine neoplasia type 2 (MEN 2). Recent studies have also suggested an involvement ofRETin the development of the mammalian kidney. Although kidney agenesis or dysgenesis has been observed in mice lacking functionalret, no clinically relevant kidney abnormalities have been reported in individuals with knownRETmutations and familial medullary thyroid carcinoma (FMTC). We have studied a family with five members affected with isolated FMTC. DNA analysis was performed and the involvedRETmutation was identified. Amongst these patients were a woman and her son.Design. Case report.Setting. University department.Patients. A 32‐year‐old woman and her son with FMTC and unilateral renal agenesis.Results. The woman’s abdominal ultrasound findings demonstrated unilateral renal absence of the left kidney. Her son, when only a few months old, had undergone surgical treatment for Hirschsprung’s disease. Abdominal ultrasonography was performed recently, and left‐side renal absence was diagnosed. Intravenous pyelography confirmed the agenesis of his left kidney, whilst the contralateral kidney displayed compensatory hypertrophy.Conclusions. The involvement of theRETproto‐oncogene in the early growth and differentiation of the human kidney is now generally accepted. We believe that at least a proportion of patients with MEN 2 may have undiagnosed renal malformations. We suggest therefore that noninvasive imaging techniques, such as ultrasonography, should be used to explore the presence of renal abnormalities in subjects with demonstratedRETmutations.
Treatment of abdominally obese men with a serotonin reuptake inhibitor: a pilot study
Authors: Ljung T. , Ahlberg A.‐C. , Holm G. , Friberg P. , Andersson B. , Eriksson E. , Björntorp P. 
Published: March 2003

Abstract. Ljung T, Ahlberg A‐C, Holm G, Friberg P, Andersson B, Eriksson E, Björntorp P (Sahlgrenska University Hospital and University of Göteborg, Göteborg, Sweden). Treatment of abdominally obese men with a serotonin reuptake inhibitor: a pilot study. J Intern Med 2001; 250: 219–224. Objective. To investigate the effects of a selective serotonin reuptake inhibitor (SSRI) on the neuroendocrine and autonomic nervous system perturbations found in abdominal obesity. Design. Treatment for 6 months with citalopram and for 6 months with placebo using a double‐blind, cross‐over design, with a 2‐month wash‐out period between treatment periods. Subjects. Sixteen healthy men, 45–60 years, moderately obese and with an abdominal fat distribution. Measurements. Anthropometry, three different depression rating scales, serum lipids, testosterone, IGF‐I, oral glucose tolerance test (OGTT), pituitary stimulation with corticotropin releasing hormone (CRH), arithmetic stress test, and excretion of cortisol and metoxycatecholamines in urine, collected during 24 h. Results. Cortisol concentrations in the morning were low before treatment, indicating a perturbed function of the hypothalamic‐pituitary‐adrenal (HPA) axis. After treatment with citalopram morning cortisol concentrations rose to normal. Cortisol concentrations after stimulation with CRH or stress were elevated by citalopram treatment, but urinary cortisol excretion was unchanged. The glucose concentrations after OGTT (120 min) tended to be reduced, with unchanged insulin concentrations, whilst other metabolic values did not change during treatment. Heart rate after administration of CRH, and during laboratory stress test, decreased by treatment with citalopram. Diurnal urinary excretion of metoxycatecholamines tended to decrease. Neither body mass index nor waist/hip circumference ratio decreased. Depression scores were within normal limits before treatment and did not change. Conclusion. The results of this pilot study indicate improvements in the regulation of neuroendocrine‐autonomic systems as well as metabolism in abdominal obesity during treatment with an SSRI.
Adrenocorticotrophic hormone exerts marked lipid‐lowering effects in simvastatin‐treated patients
Authors: Hardarson A. , Sigurdsson G. , Olafsdottir E. , Dallongeville J. , Berg A.‐L. , Arnadottir M. 
Published: March 2003

Abstract. Hardarson A, Sigurdsson G, Olafsdottir E, Dallongeville J, Berg A‐L, Arnadottir A (Landspitali University Hospital, Reykjavik, Iceland; Institut Pasteur, Lille, France; and University Hospital, Lund, Sweden). Adrenocorticotrophic hormone exerts marked lipid‐lowering effects in simvastatin‐treated patients. J Intern Med 2001; 250: 530–534. Objective. Recently, it was reported that treatment with adrenocorticotrophic hormone (ACTH) has a strong lipid‐lowering effect in healthy individuals. The mechanism behind this has not been established. The aim of the present investigation was to study the effect of ACTH on the plasma lipoprotein pattern in patients treated with a 3‐hydroxy‐3‐methylglutaryl‐coenzyme A reductase inhibitor. Design. The ACTH treatment was given to 10 patients who were on long‐term treatment with simvastatin 40 mg daily. ACTH1‐24 was administered at the dose of 1 mg daily for four consecutive days. Blood samples for analyses of lipids, lipoproteins and apolipoproteins were collected before and after treatment. Second baseline was obtained 2 weeks after the end of treatment. Results. The serum concentrations of cholesterol, triglycerides, low density lipoprotein (LDL) cholesterol, apolipoprotein B and lipoprotein(a) fell significantly by 16, 23, 23, 10 and 38%, respectively. The serum apolipoprotein E concentration increased significantly by 39%; the fraction that was not associated with apolipoprotein B increased by 47% whereas the fraction that was did not change significantly. There were no changes in the serum concentrations of high density lipoprotein (HDL) cholesterol and apolipoprotein AI. At the second baseline, the lipid variables had generally returned to previous levels. Conclusions. In patients on long‐term simvastatin treatment, ACTH had marked lowering effects on the lipoproteins that contain apolipoprotein B. Moreover, the serum apolipoprotein E concentration increased significantly in response to ACTH treatment.
Effect of apoE genotype on the hypolipidaemic response to pravastatin in an outpatient setting
Authors: Peña R. , Lahoz C. , Mostaza J. M. , Jiménez J. , Subirats E. , Pintó X. , Taboada M. , López‐Pastor A. ,   and The Rap Study Group
Published: March 2003

Abstract. Peña R, Lahoz C, Mostaza JM, Jiménez J, Subirats E, Pintó X, Taboada M, López‐Pastor A, The RAP study group (Hospital Carlos III; Instituto de Salud Carlos III, Madrid; Hospital de Puigcerdá, Gerona; Hospital de Bellvitge, Barcelona; Centro de Salud de Fuencarral; Hospital La Paz, Madrid, Spain). Effect of apoE genotype on the hypolipidaemic response to pravastatin in an outpatient setting. J Intern Med 2002; 251: 518–525. Background. Considerable variability exists in the plasma lipid and lipoprotein response to statin treatment due, in part, to genetic factors. The gene for apolipoprotein E (ApoE) is polymorphic and the different genotypes modulate baseline lipid levels. The objective of the present study was to evaluate the effect of the apoE genotype on the lipoprotein response to pravastatin treatment in an outpatient population followed‐up in several different clinics across Spain. Subjects and methods. Subjects (n=401; 56% female; mean age 57 years), who were hypercholesterolaemic despite a diet poor in saturated fat and cholesterol, were treated according to NCEP‐ATP II guidelines. Plasma lipids and lipoproteins were measured centrally before and after 16 weeks of treatment with 20 mg day−1 of pravastatin. Results. ApoE genotype distributions were 3.2% with ɛ2/3, 73.1% with ɛ3/3 and 22.4% with ɛ3/4 or ɛ4/4. ApoE genotype did not have any effect on baseline lipid levels except on triglycerides such that the carriers of the ɛ2 allele had concentrations significantly greater than those subjects with ɛ3/3 genotype and carriers of the ɛ4 allele after adjustment for age, gender and body mass index (BMI) (P < 0.001). Once adjusted for age, gender, BMI and baseline lipid levels, the apoE polymorphism did not significantly influence the plasma lipid and lipoprotein response to pravastatin. Conclusion. ApoE genotype appears not to influence the hypolipidaemic effect of pravastatin in patients monitored in a general outpatient setting.