bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insulin induced increase in coronary flow reserve is abolished by dexamethasone in young men with uncomplicated type 1 diabetes
Authors: Laine H , Sundell J , Nuutila P , Raitakari O T , Luotolahti M , Rönnemaa T , Elomaa T , Koskinen P , Knuuti J 
Published: February 2004

Objective: To examine the role of the sympathetic nervous system in regulating insulin’s action on coronary perfusion in uncomplicated type 1 diabetes by blocking centrally mediated sympathetic activity with dexamethasone.Methods: Positron emission tomography and oxygen 15 labelled water were used to quantify myocardial blood flow basally and during adenosine infusion with or without simultaneous euglycaemic physiological hyperinsulinaemia in nine non-smoking men with type 1 diabetes and 12 healthy non-diabetic men. Each patient was studied both with and without previous dexamethasone treatment for two days (2 mg/day).Results: Insulin increased coronary flow reserve in diabetic (from 4.3 (0.7) to 5.1 (0.6), p < 0.05) and non-diabetic (from 4.3 (0.3) to 5.4 (0.4), p < 0.05) patients. In contrast to non-diabetic patients dexamethasone pretreatment abolished the insulin induced increase in coronary flow reserve in diabetic patients (p < 0.05) leading to lower coronary flow reserve in diabetic than in non-diabetic patients (3.9 (0.6) v 7.1 (0.9), p < 0.05).Conclusions: These results show that insulin’s ability to modulate coronary perfusion is sustained in young patients with type 1 diabetes without microvascular complications or autonomic neuropathy. Dexamethasone treatment abolished the insulin induced increase in coronary flow reserve in diabetic patients but not in healthy study participants, suggesting that sympathetic activation plays an important part in regulating insulin’s effects on myocardial perfusion in patients with type 1 diabetes.
Sex differences in the expression of haemorheological determinants in individuals with atherothrombotic risk factors and in apparently healthy people
Authors: Zeltser D , Rogowski O , Berliner S , Mardi T , Justo D , Serov J , Rozenblat M , Avitzour D , Shapira I 
Published: February 2004

Background: Increased red cell aggregation can be detrimental, leading to slow capillary blood flow and tissue hypoxaemia. Sex differences in the degree of erythrocyte adhesiveness/aggregation in the peripheral blood have not been clearly shown.Objectives: To determine whether there are sex differences in the expression of erythrocyte adhesiveness/aggregation in the peripheral blood in individuals with atherothrombotic risk factors and in apparently healthy people.Methods: From a cohort of 965 participants in the Tel Aviv Medical Centre inflammation survey, 192 pairs of different sex were matched for age, body mass index, hip and waist circumferences, cardiovascular risk factors, and the intake of active cardiovascular drugs.Results: Women had an enhanced degree of red cell aggregation (p < 0.0005) as well as increased concentrations of inflammation sensitive proteins including fibrinogen and C reactive protein. Women had a lower haemoglobin concentration than men, but this did not affect the degree of erythrocyte adhesiveness/aggregation.Conclusions: The significant increase in red blood cell adhesiveness/aggregation in the peripheral blood of women with atherothrombosis could be relevant to the more eventful course that some women experience during and following acute ischaemic disease.
Haemochromatosis gene mutations and risk of coronary heart disease: a west of Scotland coronary prevention study (WOSCOPS) substudy
Authors: Gunn I R , Maxwell F K , Gaffney D , McMahon A D , Packard C J 
Published: February 2004

Objectives: To measure the frequency of genotypes of the HFE (haemochromatosis) gene in patients recruited to the west of Scotland coronary prevention study (WOSCOPS), and relate them to the subsequent occurrence of coronary clinical events.Design: Nested case–control study, drawing samples of DNA from the biological bank of a cohort study.Patients: Men aged 45–64 years in 1989, with moderate hypercholesterolaemia and no evidence of coronary heart disease at baseline.Interventions: Follow up for a mean period of 4.9 years. Typing for C282Y and H63D mutations of the HFE gene in 482 subjects with a subsequent coronary event and 1104 without an event.Results: The C282Y mutation was present in 81 of 482 cases (16.8%) and 182 of 1104 controls (16.5%). Comparing the prevalence of gene mutations in the cases and controls, there were no significant differences. The hazard ratio for C282Y heterozygotes was 1.03 (95% confidence interval (CI) 0.77 to 1.36) and for C282Y/H63D compound heterozygotes 1.04 (95% CI 0.50 to 2.14). Prespecified subgroup analyses of the pravastatin, placebo, smoking, and non-smoking groups showed no significant differences between cases and controls. Repeating the analyses after adjusting for possible confounding factors produced no change in the results.Conclusions: In a population of moderately hypercholesterolaemic middle aged Scottish men who did not have any evidence of coronary heart disease at baseline, the presence of a C282Y mutation in the HFE gene did not predict the occurrence of coronary events over a mean follow up of 4.9 years.
Response of very small (2 mm) porcine coronary arteries to balloon angioplasty and stent implantation
Authors: Morton A C , Arnold N D , Crossman D C , Gunn J 
Published: February 2004

Objective: To investigate the response of very small coronary arteries to stent deployment and balloon angioplasty.Setting: Normal porcine coronary arteries.Methods: 24 pigs underwent intervention to two main coronary arteries, in segments 2.0 mm in diameter, with balloons whose diameter was 2.5 mm at standard pressure. Twelve arteries received a BiodivYsio small vessel (SV) stent; 12 an NIR SV stent; 12 standard BiodivYsio stent, and 12 balloon only. The arteries were harvested at 28 days, fixed, embedded in plastic, and cut and ground in cross section. The injury score and histomorphometry were assessed.Results: The BiodivYsio SV stent was associated with 20% less injury (p  =  0.16), a 30% larger lumen (p  =  0.13), and a 25% smaller neointima (p  =  0.03) than the NIR SV stent, despite identical oversize. The standard BiodivYsio stent exhibited less recoil but 29% greater injury (p  =  0.01), 59% more neointima (p  =  0.00), and 18% less lumen (p  =  0.27) than the BiodivYsio SV. Of all interventions, balloon only was associated with little injury, little neointima, major vessel shrinkage, and the largest lumen.Conclusion: Despite uniform oversize dilatation, both injury and response varied widely in very small porcine coronary arteries, depending on whether a stent or balloon was used, the stent design, and the number and/or thickness of struts. The response to different stent designs is considerable and is related to the degree of injury.
Diagnostic and prognostic evaluation of left ventricular systolic heart failure by plasma N-terminal pro-brain natriuretic peptide concentrations in a large sample of the general population
Authors: Groenning B A , Raymond I , Hildebrandt P R , Nilsson J C , Baumann M , Pedersen F 
Published: February 2004

Objective: To evaluate N-terminal pro-brain natriuretic peptide (NT-proBNP) as a diagnostic and prognostic marker for systolic heart failure in the general population.Design: Study participants, randomly selected to be representative of the background population, filled in a heart failure questionnaire and underwent pulse and blood pressure measurements, electrocardiography, echocardiography, and blood sampling and were followed up for a median (range) period of 805 (60−1171) days.Setting: Participants were recruited from four randomly selected general practitioners and were examined in a Copenhagen university hospital.Patients: 382 women and 290 men in four age groups (50−59 (n  =  174); 60−69 (n  =  204); 70−79 (n  =  174); ⩾ 80 years (n  =  120)).Main outcome measures: Value of NT-proBNP in evaluating patients with symptoms of heart failure and impaired left ventricular (LV) systolic function; prognostic value of NT-proBNP for mortality and hospital admissions.Results: In 38 (5.6%) participants LV ejection fraction (LVEF) was ⩽ 40%. NT-proBNP identified patients with symptoms of heart failure and LVEF ⩽ 40% with a sensitivity of 0.92, a specificity of 0.86, positive and negative predictive values of 0.11 and 1.00, and area under the curve of 0.94. NT-proBNP was the strongest independent predictor of mortality (hazard ratio (HR)  =  5.70, p < 0.0001), hospital admissions for heart failure (HR  =  13.83, p < 0.0001), and other cardiac admissions (HR  =  3.69, p < 0.0001). Mortality (26 v 6, p  =  0.0003), heart failure admissions (18 v 2, p  =  0.0002), and admissions for other cardiac causes (44 v 13, p < 0.0001) were significantly higher in patients with NT-proBNP above the study median (32.5 pmol/l).Conclusions: Measurement of NT-proBNP may be useful as a screening tool for systolic heart failure in the general population.
The politics of preventable deaths: local spending, income inequality, and premature mortality in US cities
Authors: Ronzio C R , Pamuk E , Squires G D 
Published: February 2004

Objective:To examine the association between (1) local political party, (2) urban policies, measured by spending on local programmes, and (3) income inequality with premature mortality in large US cities.Design:Cross sectional ecological study.Outcome measures:All cause death rates and death rates attributable to preventable or immediate causes for people under age 75.Predictor measures:Income inequality, city spending, and social factors.Setting:All central cities in the US with population equal to or greater than 100 000.Results:Income inequality is the most significant social variable associated with preventable or immediate death rates, and the relation is very strong: a unit increase in the Gini coefficient is associated with 37% higher death rates. Spending on police is associated with 23% higher preventable death rates compared with 14% lower death rates in cities with high spending on roads.Conclusions:Cities with high income inequality and poverty are so far unable to reduce their mortality through local expenditures on public goods, regardless of the mayoral party. Longitudinal data are necessary to determine if city spending on social programmes reduces mortality over time.
Evaluation of methodologies for small area life expectancy estimation
Authors: Eayres D , Williams E S 
Published: February 2004

Study objective:To evaluate methods for calculating life expectancy in small areas, for example, English electoral wards.Design:The Monte Carlo method was used to simulate the distribution of life expectancy (and its standard error) estimates for 10 alternative life table models. The models were combinations of Chiang or Silcocks methodology, 5 or 10 year age intervals, and a final age interval of 85+, 90+, or 95+.Setting:A hypothetical small area experiencing the population age structure and age specific mortality rates of English men 1998–2000.Participants:Routine mortality and population statistics for England.Main results:Silcocks and Chiang based models gave similar estimates of life expectancy and its standard error. For all models, life expectancy was increasingly overestimated as the simulated population size decreased. The degree of overestimation depended largely on the final age interval chosen. Life expectancy estimates of small populations are normally distributed. The standard error estimates are normally distributed for large populations but become increasingly skewed as the population size decreases. Substitution methods to compensate for the effect of zero death counts on the standard error estimate did not improve the estimate.Conclusions:It is recommended that a population years at risk of 5000 is a reasonable point above which life expectancy calculations can be performed with reasonable confidence. Implications are discussed. Within the UK, the Chiang methodology and a five year life table to 85+ is recommended, with no adjustments to age specific death counts of zero.
Linking perceptions of neighbourhood to health in Hamilton, Canada
Authors: Wilson K , Elliott S , Law M , Eyles J , Jerrett M , Keller-Olaman S 
Published: February 2004

Study objective:To investigate the association between perceptions of neighbourhood physical and social characteristics and three health outcomes (self assessed health status, chronic conditions, and emotional distress).Design:Cross sectional survey data analysed in small neighbourhoods.Setting:Hamilton, Ontario, Canada, a medium sized industrial city, located at the western end of Lake Ontario (population at the time of the study about 380 000).Participants:Random sample of 1504 adults aged 18 years and older residing in four contrasting neighbourhoods.Main results:Significant differences across the four neighbourhoods are apparent in self assessed health status and emotional distress, but not in chronic conditions. Neighbourhoods with lower SES reported poorer health and more emotional distress. Perceptions of the physical environment dominated social concerns in all neighbourhoods. For all three health outcomes, individual risk factors followed expectations, with measures of poverty, age, and lifestyle all significantly associated with poor health outcomes. Physical environmental problems were positively and significantly associated with poor physical and emotional health. Specifically, people reporting they dislike aspects of their neighbourhood’s physical environment are 1.5 times more likely to report chronic health conditions (OR 1.56, 95% CI 1.19 to 2.05), while those reporting physical likes with their neighbourhood are less likely to report fair/poor health (OR 0.50, 95% CI 0.28 to 0.90) or emotional distress (OR 0.45, 95% CI 0.26 to 0.80).Conclusions:These results demonstrate the importance of neighbourhood perceptions as a determinant of health, as well as conventional factors such as low income, lifestyle, and age. The dominance of physical environmental concerns may have arisen from the industrial nature of Hamilton, but this result merits further investigation.
Modelling potential responses to severe acute respiratory syndrome in Japan: the role of initial attack size, precaution, and quarantine
Authors: Nishiura H , Patanarapelert K , Sriprom M , Sarakorn W , Sriyab S , Ming Tang I 
Published: February 2004

Background:There has been an outbreak of the severe acute respiratory syndrome (SARS) worldwide. With the use of detailed epidemiological data from other countries, this article describes the possible reason for the SARS epidemic not appearing in Japan, and simulates the impact of different control strategies that can break the transmission cycle of SARS associated coronavirus.Method:Mathematical modelling is used for predicting the epidemiological outcome and simultaneously for evaluating the effect of interventions on SARS. The study estimates the initial attack size that would result in failed invasion. Three different interventions have been incorporated into the public health response policies; precautionary public health measures, isolation of infected people, and quarantine of exposed humans.Results:The maximum number of humans newly infected could be roughly estimated on the basis of the initial attack size, using simple formulas. It is seen that the introduction of only a few cases into certain communities would not lead easily to an epidemic. The possible trajectories of SARS epidemic depend on the levels of public health interventions as quarantine and precautionary public health measures greatly affected the transmissibility of the disease. It is shown that there exist threshold levels of interventions at which the SARS epidemic settles down.Conclusion:Initial attack size is one of the determinants of whether SARS can successfully invade the community or not. Two of the most effective policy procedures to prevent new infections would be to apply stringent precautionary measures and to impose quicker and more effective quarantine of the exposed populace.
The role of individual and contextual socioeconomic circumstances on mortality: analysis of time variations in a city of north west Italy
Authors: Marinacci C , Spadea T , Biggeri A , Demaria M , Caiazzo A , Costa G 
Published: February 2004

Study objective:To evaluate the independent and mutual effects of neighbourhood deprivation and of individual socioeconomic conditions on mortality and to assess the trends over the past 30 years and the residual neighbourhood heterogeneity.Design:General and cause specific mortality was analysed as a function of time period, highest educational level achieved, housing conditions, and neighbourhood deprivation, using multilevel Poisson models stratified by gender and age class.Setting:The study was conducted in Turin, a city in north west Italy with nearly one million inhabitants and consisting of 23 neighbourhoods.Participants:The study population included three cohorts of persons aged 15 years or older, recorded in the censuses of 1971, 1981, and 1991 and followed up for 10 years after each census.Main results:Individual and contextual socioeconomic conditions showed an independent and significant impact on mortality, both among men and women, with significantly higher risks for coronary heart and respiratory diseases among people, aged less than 65 years, residing in deprived neighbourhoods (9% and 15% excess for coronary heart diseases, 20% and 24% for respiratory diseases, respectively for men and women living in deprived neighbourhoods compared with rich). The decreasing time trend in general mortality was less pronounced among men with lower education and poorer housing conditions, compared with their more advantaged counterparts; the same was found in less educated women aged less than 65 years.Conclusions:These results and further developments in the evaluation of impact and mechanisms of other contextual effects can provide information for both health and non-health oriented urban policies.
Universal changes in biomarkers of coagulation and inflammation occur in patients with severe sepsis, regardless of causative micro-organism [ISRCTN74215569]
Authors: Kinasewitz Gary T , Yan S Betty , Basson Bruce , Comp Philip , Russell James A , Cariou Alain , Um Suzane L , Utterback Barbara , Laterre Pierre-Francois , Dhainaut Jean-François ,   for the PROWESS Sepsis Study Group
Published: February 2004

Abstract
Introduction
PROWESS (Recombinant Human Activated Protein C Worldwide Evaluation in Severe Sepsis) was a phase III, randomized, double blind, placebo controlled, multicenter trial conducted in patients with severe sepsis from 164 medical centers. Here we report data collected at study entry for 1690 patients and over the following 7 days for the 840 patients who received placebo (in addition to usual standard of care).

Methods
Nineteen biomarkers of coagulation activation, anticoagulation, fibrinolysis, endothelial injury, and inflammation were analyzed to determine the relationships between baseline values and their change over time, with 28-day survival, and type of infecting causative micro-organism.

Results
Levels of 13 of the 19 biomarkers at baseline correlated with Acute Physiology and Chronic Health Evaluation II scores, and nearly all patients exhibited coagulopathy, endothelial injury, and inflammation at baseline. At study entry, elevated D-dimer, thrombin–antithrombin complexes, IL-6, and prolonged prothrombin time were present in 99.7%, 95.5%, 98.5%, and 93.4% of patients, respectively. Markers of endothelial injury (soluble thrombomodulin) and deficient protein C, protein S, and antithrombin were apparent in 72%, 87.6%, 77.8%, and 81.7%, respectively. Impaired fibrinolysis (elevated plasminogen activator inhibitor-1) was observed in 44% of patients. During the first 7 days, increased prothrombin time (which is readily measurable in most clinical settings) was highly evident among patients who were not alive at 28 days.

Conclusion
Abnormalities in biomarkers of inflammation and coagulation were related to disease severity and mortality outcome in patients with severe sepsis. Coagulopathy and inflammation were universal host responses to infection in patients with severe sepsis, which were similar across causative micro-organism groups.
Mammaglobin Is Associated With Low-Grade, Steroid Receptor-Positive Breast Tumors From Postmenopausal Patients, and Has Independent Prognostic Value for Relapse-Free Survival Time
Authors: Span Paul N. , Waanders Esmé , Manders Peggy , Heuvel Joop J.T.M. , Foekens John A. , Watson Mark A. , Beex Louk V.A.M. , Sweep Fred C.G.J. 
Published: February 2004

Purpose The tumor mRNA expression levels of mammaglobin, a novel breast-specific and breast cancer-associated marker, were correlated with disease outcome in 280 patients with primary breast cancer. Patients and Methods Mammaglobin expression levels were assessed by quantitative reverse transcriptase polymerase chain reaction in frozen tumor tissue from breast cancer patients with a median age of 60 years (range, 30 to 88 years) and a median follow-up of 85 months (range, 2 to 169 months). Results High expression levels were associated with low-grade tumors (P = .018), with positive estrogen and progesterone receptor status (P < .001), and postmenopausal status (P = .010). In the analysis of all patients, low tumor mammaglobin expression levels predicted an early relapse both in Cox univariate (hazard ratio [HR], 0.52; 95% CI, 0.34 to 0.79; P = .002) and multivariate regression analyses corrected for the traditional prognostic factors (HR, 0.55; 95% CI, 0.35 to 0.88; P = .012). The association of mammaglobin expression with the rate of relapse was particularly favorable in patients who received adjuvant tamoxifen treatment (HR, 0.35; 95% CI, 0.17 to 0.71; P = .004). Conclusion These results demonstrate that the assessment of the tumor mRNA expression level of the breast-specific protein mammaglobin could be useful to stratify patients for individual adjuvant treatment strategies.
Paclitaxel 175 or 225 mg per Meters Squared With Carboplatin in Advanced Ovarian Cancer: A Randomized Trial
Authors: Bolis Giorgio , Scarfone Giovanna , Polverino Gianpiero , Raspagliesi Francesco , Tateo Saverio , Richiardi Giovanni , Melpignano Mauro , Franchi Massimo , Mangili Giorgia , Presti Mauro , Villa Antonella , Conta Enrico , Guarnerio Paolo , Cipriani Sonia , Parazzini Fabio 
Published: February 2004

Purpose To analyze the effect of different doses of paclitaxel with fixed doses of carboplatin in the treatment of ovarian cancer. Patients and Methods Patients with histologically confirmed epithelial ovarian cancer, International Federation of Gynecology and Obstetrics stages IIB to IV, were eligible for this randomized, multicenter study. Women were randomly assigned to treatment with (1) carboplatin at the dose (in milligrams) corresponding to the following formula: target area under the free carboplatin plasma concentration versus time curve (AUC) = 6 × (glomerular filtration rate + 25) mg/m2 (AUC6) plus paclitaxel 175 mg/m2 for six cycles every 21 days or (2) carboplatin AUC6 plus paclitaxel 225 mg/m2 for six cycles every 21 days. A total of 502 women entered the study. Results Pathologic complete response was documented in 132 patients (63.8%) in the 175 mg/m2 group and in 127 cases (55.7%) in the 225 mg/m2 group (χ2 P = .090). The 4-year progression-free survival rate was 41.5% (SE = 3.5) in the 175-mg group and 39.2% (SE = 3.5) in the 225-mg group. The corresponding 4-year survival rates were 46.2% (based on 115 deaths) and 47.3% (based on 113 deaths), respectively. Conclusion This randomized trial suggests that paclitaxel 175 mg/m2 plus carboplatin AUC6 is the schedule with a more favorable profile than paclitaxel 225 mg/m2 plus carboplatin AUC6.