bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does immigration contribute to decreasing CHD incidence? Coronary risk factors among immigrants in Göteborg, Sweden
Authors: Dotevall A. , Rosengren A. , Lappas G. , Wilhelmsen L. 
Published: March 2003

Abstract.  Dotevall A, Rosengren A, Lappas G, Wilhelmsen L (Sahlgrenska University Hospital at Ostra, Göteborg University, Göteborg, Sweden). Does immigration contribute to decreasing CHD incidence? Coronary risk factors among immigrants in Göteborg, Sweden. J Intern Med 2000; 247: 331–339.Objectives.  To investigate if an increasing proportion of immigrants may have contributed to the decreasing trend in coronary heart disease (CHD) in Sweden during the last few decades and to analyse the cardiovascular risk factor pattern in immigrants compared to Swedish‐born subjects.Population and methods.  CVD risk factors were investigated within the framework of the WHO MONICA project. A random sample of 1618 men and women aged 25–64  years responded to the invitation to a screening procedure including questionnaires and physical and laboratory examination. Data on myocardial infarctions (MI) were collected from the Göteborg Myocardial Infarction Register. Data from the City Council secretariat were used to estimate the number of immigrants in the total population.Results.  In 1995, immigrants constituted 22.4% of the population between 25 and 64 years of age in Göteborg. The incidence of MI in immigrants, 21.7%, was similar to that in Swedish‐born subjects. Non‐Finnish immigrants reported more unemployment, low physical activity during leisure time and psychological stress than Swedish subjects. Immigrant men also smoked more. BMI and WHR were significantly higher in immigrant women and Finnish immigrants had higher blood pressure than Swedes. Total‐ and LDL‐cholesterol were higher in Finnish men. HDL‐cholesterol was significantly lower and s‐triglycerides significantly higher in non‐Finnish immigrants of both genders.Conclusion.  The decreasing trend in CHD in Sweden during the last few decades is not due to an increasing number of immigrants from ‘low‐risk countries’. On the contrary, the immigrants in the present study seem to have a worse CVD risk factor profile than Swedes.
Globalization, coca‐colonization and the chronic disease epidemic: can the Doomsday scenario be averted?
Authors: Zimmet P. 
Published: March 2003

Abstract. Zimmet P (International Diabetes Institute, Melbourne, Australia). Globalization, coca‐colonization and the chronic disease epidemic: can the Doomsday scenario be averted? J Intern Med 2000; 247: 301–310.There are at present approximately 110 million people with diabetes in the world but this number will reach over 220 million by the year 2010, the majority of them with type 2 diabetes. Thus there is an urgent need for strategies to prevent the emerging global epidemic of type 2 diabetes to be implemented. Tackling diabetes must be part of an integrated program that addresses lifestyle related disorders. The prevention and control of type 2 diabetes and the other major noncommunicable diseases (NCDs) can be cost‐ and health‐effective through an integrated (i.e. horizontal) approach to noncommunicable diseases disease prevention and control. With the re‐emergence of devastating communicable diseases including AIDS, the Ebola virus and tuberculosis, the pressure is on international and regional agencies to see that the noncommunicable disease epidemic is addressed.The international diabetes and public health communities need to adopt a more pragmatic view of the epidemic of type 2 diabetes and other noncommunicable diseases. The current situation is a symptom of globalization with respect to its social, cultural, economic and political significance. Type 2 diabetes will not be prevented by traditional medical approaches; what is required are major and dramatic changes in the socio‐economic and cultural status of people in developing countries and the disadvantaged, minority groups in developed nations. The international diabetes and public health communities must lobby and mobilize politicians, other international agencies such as UNDP, UNICEF, and the World Bank as well as other international nongovernmental agencies dealing with the noncommunicable diseases to address the socio‐economic, behavioural, nutritional and public health issues that have led to the type 2 diabetes and noncommunicable diseases epidemic. A multidisciplinary Task Force representing all parties which can contribute to a reversal of the underlying socio‐economic causes of the problem is an urgent priority.
Primary prophylaxis for individuals with severe haemophilia: how many hospital visits could treatment prevent?
Authors: Miners A. H. , Sabin C. A. , Tolley K. H. , Lee C. A. 
Published: March 2003

Abstract. Miners AH, Sabin CA, Tolley KH, Lee CA (Royal Free Hospital School of Medicine, London; University of Nottingham, Nottingham; and Royal Free Hampstead NHS Trust, London, UK). Primary prophylaxis for individuals with severe haemophilia: how many hospital visits could treatment prevent? J Intern Med 2000; 247: 493–499.Objectives. To assess how many hospital visits primary prophylaxis with clotting factor could prevent.Design. The potential for reducing hospital visits was assessed by comparing rates of in‐patient, Out‐patient and day‐case visits per patient‐year for individuals with severe (< 1 IU dL–1) haemophilia who had never received primary prophylaxis with attendance rates for individuals with mild/moderate (1–50 IU dL–1) haemophilia. Hospital attendance data were collected retrospectively for the period 1988–97 inclusive for individuals who were aged 18 years or over.Setting. Data were obtained on patients who were registered at the Katharine Dormandy Haemophilia Centre (KDHC), London, UK.Outcome measures. In‐patient stays, Out‐patient and day‐case visits.Results. Individuals with mild/moderate haemophilia were 45% (31–56), 36% (30–41) and 70% (68–73) less likely to have required in‐patient, Out‐patient and day‐case visits than were individuals with severe haemophilia. HIV serostatus and age were also shown to be significant and independent predictors of the rate of Out‐patient and day‐case visits, but not the rate of in‐patient stays.Conclusion. These results suggest that primary prophylaxis for individuals with severe haemophilia could significantly reduce the demand for in‐patient stays, and Out‐patient and day‐case visits.
Carotid atherosclerosis, vascular risk profile and mortality in a population‐based sample of functionally healthy elderly subjects: the Berlin Ageing Study
Authors: Hillen T. , Nieczaj R. , Münzberg H. , Schaub R. , Borchelt M. , Steinhagen‐Thiessen E. 
Published: March 2003

Abstract. Hillen T, Nieczaj R, Münzberg H, Schaub R, Borchelt M, Steinhagen‐Thiessen E (Humboldt‐University Berlin, Berlin; Department of Public Health Medicine/King’s College London, London; and Klinikum der Hansestadt Stralsund, Stralsund, Germany). Carotid atherosclerosis, vascular risk profile and mortality in a population‐based sample of functionally healthy elderly subjects: the Berlin Ageing Study. J Intern Med 2000; 247: 679–688.Objectives. Studies on extracranial carotid atherosclerosis have predominately been undertaken on middle‐aged subjects. This study examines the prevalence of extracranial carotid atherosclerosis, its relation to vascular risk factors and its significance for survival in elderly subjects.Design. Population‐based cross‐sectional survey. Non‐modifiable vascular risk factors examined were family history of atherosclerotic disease, sex and apolipoprotein E (apoE) genotype. Potentially modifiable risk factors assessed were smoking, fibrinogen, fasting lipids, body mass index, hypertension and diabetes.Setting and subjects. Two hundred and twenty‐five functionally healthy volunteers of the Berlin Ageing Study, aged 70–100.Main outcome measures. Presence of carotid stenosis and plaque ascertained by ultrasound imaging; 5‐year mortality.Results. At least one plaque was found in 144 (64%) of the volunteers; 34 (15%) had a stenosis over 50%; and nine (4%) had a stenosis over 75%. Total cholesterol > 6.5 mmol L–1, LDL cholesterol > 4.6 mmol L–1 and total cholesterol/HDL cholesterol ratio > 5 were significantly associated with presence of plaque in 70‐ to 80‐year‐old subjects, as was diabetes in subjects over 80 years. Log‐linear analyses showed significant three‐way interactions for high LDL cholesterol and diabetes with plaques and age. Family history, sex, apoE genotype, smoking and fibrinogen were not related to presence of plaque in the study population. Cox regression analysis revealed increased 5‐year mortality rates for subjects with plaques (OR = 2.88; 95% CI = 1.30–6.35), whereas the vascular risk profile was not associated with mortality.Conclusions. In a population‐based sample of functionally healthy elderly subjects, the significance of the vascular risk profile seemed to be diminished. It had no impact on survival and only modifiable risk factors showed an age‐dependent association with carotid disease.
Serum level of soluble tumour necrosis factor receptor II (75 kDa) indicates inflammatory activity of sarcoidosis
Authors: Ziegenhagen M. W. , Fitschen J. , Martinet N. , Schlaak M. , Müller‐Quernheim J. 
Published: March 2003

Abstract. Ziegenhagen MW, Fitschen J, Martinet N, Schlaak M, Müller‐Quernheim J (Medical Hospital, Borstel, Germany and INSERM U.14, Vandoevre‐Les‐Nancy, France). Serum level of soluble tumour necrosis factor receptor II (75 kDa) indicates inflammatory activity of sarcoidosis. J Intern Med 2000; 248: 33–41.Objectives. Tumour necrosis factor α (TNFα) is a key cytokine involved in granuloma formation of sarcoidosis. Since soluble TNF receptors (sTNF‐R) are known to inhibit TNF effects, we were interested in whether they are elevated in the serum of sarcoidosis patients.Methods. We determined serum levels of sTNF‐R I (55 kDa) and sTNF‐R II (75 kDa) in 49 patients with sarcoidosis and 22 controls. The clinical course of the disease was re‐evaluated in a follow‐up after (mean ± SE) 6.8 ± 6.6 months.Results. sTNF‐R I (3.1 ± 1.1 ng mL–1, P < 0.05) and sTNF‐R II (5.5 ± 2.7 ng mL–1, P < 0.0005) were significantly elevated in sarcoidosis compared with controls (2.4 ± 0.7 and 3.0 ± 1.3 ng mL–1, respectively). Interestingly, both sTNF receptors were significantly higher in the serum of patients with active compared with inactive sarcoidosis (P < 0.005 and P < 0.0005, respectively). Furthermore, serum sTNF‐R II levels were significantly higher in sarcoidosis patients with advanced radiological types II and III. In 10 patients, serum sTNF‐R levels were obtained before and after systemic corticosteroid therapy and we observed a significant decrease of sTNF‐R II (P < 0.02), whereas sTNF‐R I levels were not reduced significantly.Conclusions. Both types of sTNF receptors are elevated in the serum of sarcoidosis patients with active disease, but only the sTNF‐R II seems to be useful for monitoring the inflammatory activity of the disease.
Sleep‐disordered breathing and glucose metabolism in hypertensive men: a population‐based study
Authors: Elmasry A. , Lindberg E. , Berne C. , Janson C. , Gislason T. , Tageldin M. Awad , Boman G. 
Published: March 2003

Abstract. Elmasry A, Lindberg E, Berne C, Janson C, Gislason T, Awad Tageldin M, Boman G (Uppsala University, Akademiska Sjukhuset, Uppsala, Sweden; Ain Shams University, Cairo, Egypt; and Vifilsstadir Hospital, Gardabaer, Iceland). Sleep‐disordered breathing and glucose metabolism in hypertensive men: a population‐based study. J Intern Med 2001; 249: 153–161. Objectives. Diabetes mellitus and obstructive sleep apnoea (OSA) are two prevalent medical problems. Both are strongly associated with obesity and hypertension. The aim of this study was to investigate whether the association between OSA and diabetes is entirely dependent on obesity in hypertensive men. Design. A population‐based study. Setting. The municipality of Uppsala, Sweden. Subjects and methods. In 1994, 2668 men aged 40–79 years answered a questionnaire regarding snoring, sleep disturbances and somatic diseases. An age‐stratified sample of 116 hypertensive men was selected for a whole‐night sleep study. Twenty‐five of them had diabetes, defined as reporting regular medical controls for diabetes or having a fasting blood glucose ≥6.1 mmol L−1. Results. The prevalence of severe OSA, defined as apnoea‐hypopnoea index (AHI) ≥20 h−1 was significantly higher in diabetic patients than in normoglycaemic subjects (36 vs. 14.5%, P < 0.05). The sample was divided into four groups based on the presence or absence of severe OSA and the presence or absence of central obesity, defined as waist‐to‐hip ratio (WHR) ≥1.0. In a logistic regression model with the non‐OSA, WHR <1.0 as the reference group, the adjusted odds ratio (95% confidence interval) for diabetes was 11.8 (2.0–69.8) in the OSA, WHR ≥1.0 group, whilst it was 3.6 (0.9–14.8) in the non‐OSA, WHR ≥1.0 group and 5.7 (0.3–112) in the OSA, WHR <1.0 group. In a linear regression model, after adjustment for WHR, there was a significant relationship between variables of sleep‐disordered breathing and fasting insulin, glucose and haemoglobin A1c. Conclusions. We conclude that, in hypertensive men, although obesity is the main risk factor for diabetes, coexistent severe OSA may add to this risk. Sleep breathing disorders, independent of central obesity, may influence plasma insulin and glycaemia.
The role of gene–environment interaction in the aetiology of human cancer: examples from cancers of the large bowel, lung and breast
Authors: Mucci L. A. , Wedren S. , Tamimi R. M. , Trichopoulos D. , Adami H.‐O. 
Published: March 2003

Abstract. Mucci LA, Wedren S, Tamimi RM, Trichopoulos D, Adami H.‐O. (Harvard School of Public Health, Boston, MA, USA; and Karolinska Institutet, Stockholm, Sweden) The role of gene–environment interaction in the aetiology of human cancer: examples from cancers of the large bowel, lung and breast. J Intern Med 2001; 249: 477–493.It has become increasingly clear that cancer can be considered neither purely genetic nor purely environmental. A relatively new area of cancer research has focused on the interaction between genes and environment in the same causal mechanism. Primary candidates for gene‐environment interaction studies have been genes that encode enzymes involved in the metabolism of established cancer risk factors. There are common variant forms of these genes (polymorphisms), which may alter metabolism and increase or decrease exposure to carcinogens, thus impacting the risk of cancer. We present an overview of enzymes involved in carcinogen metabolism, present epidemiological tools to evaluate gene‐environment interactions, and provide examples from cancers of the breast, lung and large bowel.
Gender difference in age‐related changes in vascular function
Authors: Jensen‐Urstad K. , Johansson J. 
Published: March 2003

Jensen‐Urstad K, Johansson J (Karolinska Hospital, Stockholm, Sweden) Gender difference in age‐related changes in vascular function. J Intern Med 2001; 250: 29–36. Purpose. We investigated whether, in a randomly selected population of 55‐year‐old men and women, there is a relationship between vascular function measured as flow‐mediated (endothelium‐dependent) and nitroglycerine‐mediated (nonendotheliumdependent) dilatation of the brachial artery and conventional risk factors for cardiovascular disease such as gender, smoking, elevated blood‐lipids and high blood pressure. The results are compared with those in a young healthy population of 35‐year‐olds. Subjects. A total of 57 men (73% of the invited males) living in the community and 47 women (62% of the invited females) participated and were compared with a previously studied 35‐year‐old population (52 men and 56 women). Methods. Basal brachial artery diameter was measured by high‐frequency ultrasound methods. Endothelial function was measured as flow‐mediated dilatation (FMD) in response to reactive hyperaemia. The nonendothelium‐dependent vasodilatation was measured after administering sublingual nitroglycerine (NTG). Results. Flow‐mediated endothelium‐dependent dilatation was similar in men and women being 3.1 ± 2.5% (mean ± SD) in men vs. 2.6 ± 2.3% in women. FMD of the brachial artery was negatively correlated with vessel size in both men and women (P < 0.001). Men had larger brachial artery diameter than women (4.6 ± 0.7 vs. 3.6 ± 0.4 mm, P < 0.001). There was no difference in FMD or in NTG‐induced dilatation in the women receiving oral oestrogen replacement therapy compared with those that did not. The women taking oral oestrogen had lower cholesterol than those not taking oral oestrogen (P=0.04). FMD was not correlated with any of the risk factors. NTG‐induced vasodilatation was correlated with the body mass index (BMI) in men (P=0.01) and a combined risk factor score in women (P=0.04). There was a large increase in the number of subjects with cardiovascular risk factors in the 55‐year‐old men and women compared with the 35‐year‐olds. The distribution of risk factors was fairly equal amongst men and women. Conclusion. There are no correlations between any of the conventional cardiovascular risk factors and FMD in a population of 55‐year‐olds, but there is a high prevalence of risk factors in the 55‐year‐old age group. NTG‐induced vasodilatation correlated with the BMI in men and a combined risk‐factor score in women. FMD‐induced vasodilatation is smaller in women at 55 years of age than at 35 years of age. FMD was similar in men at 35 and 55 years of age and in men and women at 55 years of age. The smaller FMD in women at 55 years of age, compared with at 35, could be due to postmenopausal hormonal changes.
The yield of a diagnostic hospital dyspnoea clinic for the primary health care section
Authors: Nielsen L. Svendstrup , Svanegaard J. , Wiggers P. , Egeblad H. 
Published: March 2003

Abstract. Svendstrup Nielsen L, Svanegaard J, Wiggers P, Egeblad H (Haderslev Hospital; Aarhus University Hospital, Skejby, Denmark). The yield of a diagnostic hospital dyspnoea clinic for the primary health care section. J Intern Med 2001; 250: 422–428. Objective. To investigate the impact of a combined examination programme with treatment advice on with dyspnoea. Design. Prospective study with 6 months follow‐up. Setting. Regional hospital offering care for patients from 74 general practitioners. Subjects. A total of 284 consecutive patients referred from general practice with dyspnoea. Interventions. Patients were subjected to a combined examination programme including physical examination, ECG, chest X‐ray, lung spirometry, echocardiography and routine laboratory tests. Main outcome measures. (i) Relationship between a diagnosis made by the referring general practitioner and the diagnosis based on the combined examination programme. (ii) The impact of the investigation programme and resulting therapeutic advice on dyspnoea after 6 months. Results. Only in 39% of the patients there was concordance of the diagnoses on referral and the diagnosis based on the examination programme. Heart failure and lung disease was suspected in 126 and 79 patients, respectively, but these diagnoses were confirmed in only one‐third to half of the patients. Conversely heart failure was revealed in 13 of 107 patients not suspected of heart failure (12%) and lung disease in 45 of 154 patients not suspected of pulmonary disease (29%). A change of treatment was suggested in 64% of all patients. After 6 months, improvement of dyspnoea was seen in more than half of the patients. In patients in whom the changes of medical treatment were completed, 61% expressed improvement in dyspnoea, whereas improvement of dyspnoea was recorded in only 34% of patients in whom the recommended treatment advice was not taken (P < 0.01). Conclusion. (i) In most patients it seems to be too difficult to establish the background of dyspnoea in general practice. (ii) There appears to be a substantial chance of improvement in patients with dyspnoea, in particular for patients who act on treatment advice based on an integrated examination programme; the chance of improvement is almost twice as good as in patients who are not capable to do so.
Reduction of free radical activity in amyloid deposits following liver transplantation for familial amyloidotic polyneuropathy
Authors: Nyhlin N. , Anan I. , El Salhy M. , Ando Y. , Suhr O. B. 
Published: March 2003

Abstract. Nyhlin N, Anan I, el Salhy M, Ando Y, Suhr OB (Umeå University Hospital, Umeå, Sweden and Kumamoto University Hospital, Kumamoto, Japan). Reduction of free radical activity in amyloid deposits following liver transplantation for familial amyloidotic polyneuropathy. J Intern Med 2002; 251: 136–141. Objectives. Liver transplantation halt the progress of familial amyloidotic polyneuropathy (FAP). Oxidative stress has been implicated in amyloid toxicity and formation. The objective of this study was to establish whether markers for oxidant stress and antioxidant capacity change following liver transplantation in patients with FAP. Design. Morphometric and biochemical study. Setting. Tertiary referral centre. Subjects. Duodenal biopsy samples from 16 patients, taken before and after liver transplantation were used for morphometry. Serum samples from 14 patients, seven of whom had received transplants, were analysed regarding antioxidant capacity. Intervention. Liver transplantation. Main outcome measures. Immunohistochemistry was used to stain for the lipid peroxidation product 4‐hydroxynonenal (HNE), and Congo red staining was used for amyloid detection. Positive areas were quantified by point counting. Total antioxidant capacity (TAC) was measured with a colourimetric assay. Results. In tissue, a decrease of HNE was noted after liver transplantation, whereas no significant changes were detected for amyloid deposits. No difference between transplanted and not transplanted patients was noted for total antioxidant capacity measured in serum. Conclusion. To our knowledge, this is the first description of a reduction of markers for free radical activity after cessation of amyloid formation. The findings implicate that amyloid formation in transthyretin (TTR) amyloidosis generates oxidative stress, whereas amyloid deposits as such are less toxic to sourroundig tissues.