bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sarcoidosis causes abnormal seasonal variation in 1,25‐dihydroxy‐cholecalciferol
Authors: BONNEMA S. J. , MØLLE R J. , MARVING J. , KVETNY J. 
Published: November 2003

Bonnema SJ, Møller J, Marving J, Kvetny J (Departments of Internal Medicine and Clinical Physiology and Nuclear Medicine, Esbjerg Centralsygehus, Esbjerg, Denmark). Sarcoidosis causes abnormal seasonal variation in 1,25‐dihydroxy‐cholecalciferol. J Intern Med 1996; 239: 393–98. Objectives. The spontaneous seasonal variations in the calcium regulating hormones 1,25‐dihydroxy‐cholecalciferol (1,25‐DHCC) and parathyroid hormone (PTH) were investigated in patients with sarcoidosis. Design. Controlled, prospective observational study with measurements in the winter and summer seasons, respectively. Subjects. Twelve patients (age: median 33, range 21–54 years) with biopsy‐verified (n=8) sarcoidosis were included as well as 11 age‐matched healthy control subjects. Main outcome measures. Serum values of calcium, ionized calcium, phosphate, chloride, bicarbonate, creatinine, albumin, angiotensin‐converting enzyme, alkaline phosphatase, 1,25‐DHCC, and PTH. Also, 24‐h whole‐body retention of 99mTc methylene‐diphosphonate was assessed. Results. The patient group showed an increased level of 1,25‐DHCC in the summer season (w:146±67, s:198±73 pmol L‐1; P<0.01) in contrast to the opposite finding among controls (w:161±34, s:144±43 pmol L‐1; P<0.05). Comparing the individual seasonal changes between the two groups, the difference was marked (P<0.001). Compared with controls, total serum calcium was elevated in the summer season in the patient group (P<0.05), in which the same parameter correlated positively with 1,25‐DHCC (r=0.658; P<0.01). PTH was increased two to three times above the control values throughout the year (patients: w:0.37±0.13, s:0.24±0.08 μg L‐1; controls: w:0.14±0.09, s:0.10±0.04 μg L‐1; P<0.001); although, the level of this hormone was still found within the reference interval. 24‐h whole body bone scintigraphy failed to show any seasonal variation in bone metabolism. In contrast, serum alkaline phosphatase was found to be increased during the summer season compared with the control group (P<0.001). Angiotensin‐converting enzyme showed no seasonal variation. Conclusions. In sarcoidosis, 1,25‐DHCC is abnormally regulated throughout the year, with a significantly higher serum level in the summer season. Uncontrolled production of 1,25‐DHCC in sarcoid pulmonary alveolary macrophages is possibly responsible for hypercalcaemic episodes, and this parameter should be used as a marker of disease activity.
Daytime sleepiness in an adult, Finnish population
Authors: HUBLIN C. , KAPRIO J. , PARTINEN M. , HEIKKILÄ K. , KOSKENVUO M. 
Published: November 2003

Hublin C, Kaprio J, Partinen M, Heikkilä K, Koskenvuo M (Departments of Psychiatry and Neurology and the Department of Public Health (The Finnish Twin Cohort), University of Helsinki, Helsinki; and the Department of Public Health, University of Turku, Turku; Finland). Daytime sleepiness in an adult, Finnish population. J Intern Med 1996; 239: 417–23. Objectives. To investigate the prevalence of and the factors associated with daytime sleepiness occurring every or almost every day. Design. A cross‐sectional, questionnaire survey. Subjects. A total of 11354 adults (aged 33–60 years) representative of the Finnish population. Main outcome measures. Frequency of daytime sleepiness, naps and sleep attacks; occurrence of emotion‐associated muscle weakness, sleep debt, insomnia, sleep apnoeas and type of snoring; Beck Depression Inventory score; and the use of hypnotics and tranquillisers. Results. A total of 11.0% of women and 6.7% of men suffered from daytime sleepiness every or almost every day. Amongst those with sleepiness (n= 1026) 19.5% of women and 42.3% of men reported snoring 3 nights per week, 25% had scores suggesting moderate to severe depression, 11% used hypnotics or tranquilizers on more than 180 days per year, and 9% reported insufficient sleep. Insomnia at least every other day was reported by 20.7% of women and by 28.6% of men. Amongst those with sleepiness, narcolepsy was found in 0.3%, with the diagnosis confirmed in a sleep laboratory evaluation. Conclusions. Daytime sleepiness occurring daily or almost daily is most often associated with depression, insomnia and sleep‐disordered breathing. In most cases, indications of the cause of sleepiness can be obtained by using simple screening questions.
Lipoprotein lipase in relation to inflammatory activity in rheumatoid arthritis
Authors: WÅLLBERG‐JONSSON SOLVEIG , DAHLÉN GÖSTA , JOHNSON OWE , OLIVECRONA GUNILLA , RANTAPÄÄ‐DAHLQVIST SOLBRITT 
Published: November 2003

Objective. To evaluate the impact of chronic inflammation on lipoprotein lipase (LPL) levels and triglyceride metabolism in patients with rheumatoid arthritis (RA). Design. Plasma levels of LPL activity and mass before and after heparin were determined in post‐menopausal women with active RA and in controls. The results were related to lipid levels and inflammatory variables. The LPL activity and mass together with triglyceride levels were also measured before and 6 h after an oral fat load. Setting. The study was performed on in‐ and out‐patients at a University Rheumatology clinic. The controls came from the same reference area. Subjects. Altogether 17 consecutive post‐menopausal female patients with RA and 16 age and sex matched controls were enrolled for the initial determination of LPL. Fifteen of the patients and 15 of the controls agreed to take part in the fat load. Of these, one patient and one control were excluded. Main outcome measures. LPL determination: basal levels and post‐heparin levels of LPL activity and mass. Correlations between LPL and blood lipids (cholesterol, triglycerides), lipoprotein levels (high density lipoprotein, HDL; low density lipoprotein, LDL), erythrocyte sedimentation rate (ESR) acute phase proteins (orosomucoid, haptoglobin, fibrinogen mass) and cytokines (tumour necrosis factor α, TNF‐α; interleukin 1β, IL‐1β; and interleukin‐6, IL‐6). Fat tolerance test: LPL activity, mass and triglyceride levels before and 6 h after a per oral fat load. Results. Pre‐heparin LPL mass (P<0.01) and activity (P<0.01) were significantly lower in the rheumatoid patients. Pre‐heparin LPL mass showed no correlation to the lipid levels, but an inverse correlation to several inflammatory parameters; it was significant for orosomucoid (rs=−0.63, P<0.05) and C‐reactive protein (CRP) (rs=−0.54, P<0.05) and close to significant for haptoglobin (rs=−0.48, P=0.087) and IL‐6 (rs=−0.52, P=0.061). Six hours after a lipid load the LPL activity and mass were significantly lower in RA (P<0.05 and P<0.01, respectively) but the triglyceride level was not significantly different compared to controls. Conclusion. An inverse relationship exists between inflammatory status and pre‐heparin LPL mass. Pre‐heparin LPL mass reflects mainly the inactive monomeric fraction of LPL. This has been shown to hinder the uptake of remnant lipoprotein particles through competition with lipoprotein bound dimeric LPL for the LDL receptor‐related protein (LRP receptor) on hepatocytes and macrophages in culture. A decrease of the level of monomeric LPL in plasma may thus be beneficial for remnant catabolism. The same mechanism may on the other hand increase macrophage uptake of lipids. This may not affect global lipid metabolism but may be important in driving the atherosclerotic process in the vessel wall.
Use of low molecular weight heparin (dalteparin), once daily, for the treatment of deep vein thrombosis A feasibility and health economic study in an outpatient setting
Authors: LINDMARKER P. , HOLMSTRÖM M. ,   Swedish Venous Thrombosis Dalteparin Trial Group
Published: November 2003

Objectives. To test the safety and feasibility of treating deep vein thrombosis (DVT) in an outpatient setting, using the low molecular weight heparin dalteparin, to calculate the potential and actual cost reductions achievable as a result of such a treatment regimen. Design. An open, nonrandomized, multicentre trial. Setting. Fourteen hospitals in central Sweden. Subjects. Ambulant patients, aged 18 years or older, with symptomatic DVT in the leg, diagnosed using phlebography or ultrasound (Duplex‐Doppler). Interventions. Dalteparin (Fragmin®) at a fixed dose of 200 IU kg‐1 body weight, was administered once daily subcutaneously for at least 4 consecutive days. Treatment with warfarin was initiated from the first day of dalteparin administration. Outpatient treatment was encouraged whenever possible. Financial calculations were performed independently at two hospitals, giving an average cost for all actions. Outcome measures. Increasing severity of symptoms (or thromboembolic recurrences during the 3‐month follow‐up period), pulmonary embolism (PE), bleeding events, and death during the initial phase and follow‐up period. Results. Of 434 patients, 35% and 64% were treated in hospital within 24 and 72 h, respectively, and thereafter as outpatients. The overall frequency of serious complications was 0.92% (exact 95% confidence interval, 0.25–2.35%) during the initial phase and one patient suffered a PE and three patients had a recurrent DVT during the follow‐up period. A cost reduction of 2705529 Swedish crowns (34.5%) was achieved in this study compared with traditional in‐patient treatment. Conclusions. Dalteparin, administered subcutaneously, once daily, for the initial treatment of DVT yields large cost reductions and is well tolerated and effective in an outpatient setting.
The interaction between age and comorbidity contributes to predicting the mortality of geriatric patients in the acute‐care hospital
Authors: INCALZI R. A. , CAPPARELLA O. , GEMMA A. , LANDI F. , BRUNO E. , DI MEO F. , CARBONIN P. 
Published: November 2003

Incalzi RA, Capparella O, Gemma A, Landi F, Bruno E, Di Meo F, Carbonin P (Instituto di Medicina Interna e Geriatria dell'Universita' Cattolica del Sacro Cuore, Rome, and the Teaching Nursing Home ‘Cittadella della Carita’, Taranto, Italy. The interaction between age and comorbidity contributes to predicting the mortality of geriatric patients in the acute‐care hospital. J Intern Med 1997; 242: 291–8.ObjectiveTo test the predictive power of comorbidity and of the interaction between age and comorbidity in geriatric patients with acute medical illness.DesignProspective observational study.SettingMedical and geriatric wards of an acute‐care hospital.SubjectsThree hundred and seventy patients over 70 years of age consecutively admitted in an 18‐month period.Main outcome measureIn‐hospital mortality.MethodOn admission a multidimensional assessment was performed, and a comorbidity index and an age–comorbidity index developed on a comparable training population were calculated. The comorbidity index is based upon a scoring system that quantifies the prognostic weight of individual diseases, while the age–comorbidity index corrects the former for the age‐related increase of the risk of death. The predictive power of variables univariately correlated with the outcome was tested by logistic regression.ResultsDeath was independently predicted by clinical diagnosis of malnutrition (odds ratio = 1.87, confidence limits CL = 1.20–2.86), age–comorbidity index > 7 (odds ratio = 1.77, CL = 1.15–2.72), preadmission impairment in activities of daily living (odds ratio = 1.74, CL = 1.13–2.69), lymphocytopenia (odds ratio = 1.74, CL = 1.15–2.61). A weaker predictive model was obtained by substituting the comorbidity index for the index of age–comorbidity. Excluding comorbidity from the logistic regression greatly weakened the predictive model.
The prevention or treatment of age‐related osteoporosis in the elderly by systemic recombinant growth factor therapy (rhIGF‐I or rhTGFβ): a perspective
Authors: BOONEN S. , BROOS P. , DEQUEKER J. , BOUILLON R. 
Published: November 2003

Boonen S, Broos P, Dequeker J, Bouillon R (Department of Internal Medicine, Division of Geriatric Medicine, the Arthritis and Metabolic Bone Disease Research Unit, the Department of Traumatology and Emergency Surgery and the Laboratory for Experimental Medicine and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium). The prevention or treatment of age‐related osteoporosis in the elderly by systemic recombinant growth factor therapy (rhIGF‐I or rhTGFβ): a perspective (Review). J Intern Med 1997; 242: 285–90.Both insulin‐like growth factor‐I (IGF‐I) and transforming growth factor β (TGFβ) have powerful modulatory effects in a variety of tissues. A major target of action is the skeletal system, where they enhance bone formation and decrease matrix degradation, thus playing a part in the maintenance of bone mass. Because of the potent mitogenic effect of these agents on osteoblasts, recombinant IGF‐I (rhIGF‐I) and recombinant TGFβ (rhTGFβ) have potential as drugs to stimulate bone formation in the prevention and treatment of osteoporosis. Using biochemical markers, subcutaneous rhIGF‐I therapy has been shown to increase bone turnover and bone formation in nonosteoporotic older people. However, a corresponding increase in bone mass has not yet been documented nor have there been reports yet on the effects of systemically administered rhTGFβ in humans. Further investigation is required to define the clinical potential of rhIGF‐I and rhTGFβ as therapeutic agents in age‐related osteoporosis.
Efficacy and safety of human leucocyte interferon‐α treatment in patients younger than 60 years of age with polycythaemia vera
Authors: STASI R. , BRUNETTI M. , BUSSA S. , VENDITTI A. , DEL POETA G. , CONFORTI M. , SCIMÒ M. T. , CUDILLO L. , ADORNO G. , CECCONI M. , AMADORI S. , PAGANO A. 
Published: November 2003

Stasi R, Brunetti M, Bussa S, Venditti A, Del Poeta G, Conforti M, Scimò MT, Cudillo L, Adorno G, Cecconi M, Amadori S, Pagano A (Department of Medical Sciences, Regina Apostolorum Hospital, Albano Laziale, and Chair of Haematology, University of Rome ‘Tor Vergata’, S. Eugenio Hospital, Rome, Italy). Efficacy and safety of human leucocyte interferon‐α treatment in patients younger than 60 years of age with polycythaemia vera. J Intern Med 1997; 242: 143–7.ObjectivesTo evaluate the therapeutic activity and toxicity of human leucocyte interferon‐α (lIFN‐α) in patients with polycythaemia vera (PV) aged less than 60 years.DesignAn open clinical study.SettingDepartment of Medical Sciences, Regina Apostolorum Hospital, Albano Laziale, and Chair of Haematology, University of Rome ‘Tor Vergata’, S. Eugenio Hospital, Rome, Italy.SubjectsFourteen patients with PV and aged <60 years who had active disease as indicated by the need for phlebotomy and/or cytoreductive therapy.InterventionslIFN‐α was administered subcutaneously at the starting dose of 3 MU thrice weekly. The interferon dose could be escalated to six MU thrice weekly if it was well tolerated and disease was not controlled after three months of treatment at the lower dose.Main outcome measuresChange in phlebotomy requirements, spleen size, pruritus score and haematological parameters after 6 months of treatment. Evaluation of lIFN‐α side effects.ResultsComplete or partial disease control was achieved in 13 patients. Six patients achieved a complete response (CR) and four a partial response (PR) after 3 months of therapy. Dose escalation in partial or nonresponders resulted in two patients switching from a status of PR to CR, and three other patients achieving a partial response after being unresponsive to the lower dosage. Human leucocyte interferon‐α therapy significantly improved (P < 01) phlebotomy requirements, the degree of splenomegaly, pruritus scores, iron stores and MCV values, and platelet and leucocyte counts. A mild flu‐like syndrome (low‐grade fever, nausea and myalgias) appeared during the early phase of therapy in the majority of patients, but no patient had to discontinue lIFN‐α because of intolerance.ConclusionsSubcutaneous human leucocyte interferon‐α appears an effective and well tolerated therapy in the management of PV‐associated myeloproliferation and pruritus in patients aged less than 60 years.
Risk factors for cardiovascular disease during the period 1985–1995 in Göteborg, Sweden. The GOT‐MONICA Project
Authors: WILHELMSEN L. , JOHANSSON S. , ROSENGREN A. , WALLIN I. , DOTEVALL A. , LAPPAS G. 
Published: November 2003

Wilhelmsen L, Johansson S, Rosengren A, Wallin I, Dotevall A, Lappas G (Sahlgrenska University Hospital at Östra, Göteborg University; and Astra Hässle AB, Mölndal; Sweden). Risk factors for cardiovascular disease during the period 1985–1995 in Göteborg, Sweden. The GOT‐MONICA Project. J Intern Med 1997; 242: 199–211.AimsTo report levels of cardiovascular risk factors in 1985, 1990 and 1995 in three population samples in Göteborg, Sweden, and to compare with previous population risk factor levels.PopulationThe study was performed within the framework of the WHO MONICA Project which compares risk factor levels as well as the incidence of coronary heart disease and stroke in 38 populations.MethodsThree random samples of men and women aged 25–34, 35–44, 45–54 and 55–64 comprising 152–218 subjects in each age group who responded to the invitation for screening procedures which included questionnaires, physical and laboratory investigations in 1985, 1990 and 1995.ResultsMore men than women had smoked, except for those aged 35–44 where there was no difference between men and women. The proportion of men who had smoked decreased strongly between the first and third investigations (P < 0.0001), particularly amongst the younger age‐groups, with a similar tendency amongst women. In the 25–44‐years age group there was a tendency towards more women than men to be smokers in 1995. Snuff was used by 27% and 19% of men aged 25–34 and 35–44 years, respectively, in 1995. Up to 5% of women used snuff; higher in the younger age groups. More young men than women reported regular physical activity during leisure time with a tendency towards an increase from 1985 to 1995. The proportion of men reporting psychological stress varied little over the study period, but women aged 25–34 reported increased stress from 1985 to 1995. Body weight increased whereas height remained stable and consequently body mass index increased in men and women (P= 0.0001). Similarly, waist:hip ratio (measured in 1990 and 1995 only) also increased (P= 0.0001). Mean systolic and diastolic blood pressure increased with age and there was also a small increase between 1985 and 1995. Systolic blood pressure increased by a mean of 1.24 mmHg per 5‐year period independent of sex and age (P= 0.0001). Antihypertensive treatment increased with age, but was stable between 1985 and 1995. Serum total and LDL cholesterol concentrations increased with age, and there was a nonsignificant tendency also to higher HDL cholesterol concentrations at older ages. Serum total cholesterol concentration declined between 1985 and 1995, and HDL cholesterol declined significantly between 1985 and 1995 in all age groups for men and women only when all age groups were analysed together. Similar to total cholesterol, levels of LDL cholesterol declined between 1985 and 1995 for all ages. Serum triglyceride levels increased for men and women between 1985 and 1995.
Nephrotic syndrome and fibrillary glomerulonephritis
Authors: LAUFER J. , AUGARTEN A. , SZEINBERG A. , RAPOPORT J. , KATZENELSON D. , YAHAV Y. 
Published: November 2003

Laufer J, Augarten A, Szeinberg A, Rapoport J, Katzenelson D, Yahav Y (The Chaim Sheba Medical Center, Tel Hashomer, Affiliated to the Sackler School of Medicine, Tel Aviv, Israel). Nephrotic syndrome and fibrillary glomerulonephritis (Case Report). J Intern Med 1997; 242: 83–6.A 28‐year‐old female with cystic fibrosis presented with nephrotic syndrome and progressive renal failure. In addition, she complained of blurred vision and there was a purpuric skin eruption localized to her legs. A renal biopsy revealed fibrillary glomerulonephritis. Skin biopsy demonstrated swelling of capillary endothelium, thickening of arteriolar walls and deposition of IgA, C3 and fibrinogen by immunofluorescence. Opthalmoscopy and fluorescein angiography disclosed cotton wool spots with intraretinal haemorrhages and ischaemia of the macula. Albumin infusions resulted in worsening of eye symptoms and signs. The presence of these three clinicopathologic entities in a patient with CF may indicate the possibility of systemic involvement related to continued exposure to chronic bacterial lower lung infection.
Hyaluronan: its nature, distribution, functions and turnover
Authors: Fraser J. R. E. , Laurent T. C. , Laurent U. B. G. 
Published: November 2003

Fraser JRE, Laurent TC, Laurent UBG (Monash University, Clayton, Victoria, Australia; and University of Uppsala, Uppsala, Sweden). Hyaluronan: its nature, distribution, functions and turnover (Minisymposium: Hyaluronan). J Intern Med 1997; 242: 27–33.Hyaluronan is a polysaccharide found in all tissues and body fluids of vertebrates as well as in some bacteria. It is a linear polymer of exceptional molecular weight, especially abundant in loose connective tissue. Hyaluronan is synthesized in the cellular plasma membrane. It exists as a pool associated with the cell surface, another bound to other matrix components, and a largely mobile pool. A number of proteins, the hyaladherins, specifically recognize the hyaluronan structure. Interactions of this kind bind hyaluronan with proteoglycans to stabilize the structure of the matrix, and with cell surfaces to modify cell behaviour. Because of the striking physicochemical properties of hyaluronan solutions, various physiological functions have been assigned to it, including lubrication, water homeostasis, filtering effects and regulation of plasma protein distribution. In animals and man, the half‐life of hyaluronan in tissues ranges from less than 1 to several days. It is catabolized by receptor‐mediated endocytosis and lysosomal degradation either locally or after transport by lymph to lymph nodes which degrade much of it. The remainder enters the general circulation and is removed from blood, with a half‐life of 2–5 min, mainly by the endothelial cells of the liver sinuoids.
Hyaluronan in morphogenesis
Authors: Toole B. P. 
Published: November 2003

Toole BP (Tufts University School of Medicine, Boston, MA, USA). Hyaluronan in morphogenesis (Minisymposium: Hyaluronan). J Intern Med 1997; 242: 35–40.Pericellular matrices surrounding migrating and proliferating cells in the developing embryo, in regenerating tissues and in other dynamic cellular events, such as tumour cell invasion, are enriched in hyaluronan. In addition to contributing to the unique structure of the pericellular matrix, hyaluronan interacts with cell surface receptors, such as RHAMM and CD44. During morphogenesis, these interactions of hyaluronan with the cell surface are important in several ways. First, hyaluronan–CD44 interactions have been shown to mediate endocytic removal of hyaluronan at critical stages of embryonic development. Secondly, hyaluronan provides an appropriately hydrated, pericellular milieu that facilitates cellular invasion. Thirdly, in‐vitro studies suggest strongly that interactions of hyaluronan with RHAMM or CD44 are involved in cell movement and proliferation, which are critical events in morphogenesis.
Hyaluronan: fundamental principles and applications in cancer
Authors: DELPECH B. , GIRARD N. , BERTRAND P. , COUREL M.‐N. , CHAUZY C. , DELPECH A. 
Published: November 2003

Delpech B, Girard N, Bertrand P, Courel M‐N, Chauzy C, Delpech A (Centre Henri‐Becquerel, Rouen, France). Hyaluronan: fundamental principles and applications in cancer (Minisymposium: Hyaluronan). J Intern Med 1997; 242: 41–8.Hyaluronan (HYA) plays a particular role in cancer cell microenvironment. A component of the desmoplasia, HYA is associated to other macromolecules and contributes to the net structure of the matrix. Cancer cells exhibit binding sites (CD44, RHAMM) for HYA. The cell adhesion to HYA can influence the cell motility and different factors could interplay to facilitate cell detachment from HYA. HYA protects cancer cells against immune cell attack. Serum HYA is often increased in metastatic patients.