bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coronary artery disease and arterial hypertension: clinical, angiographic and follow‐up data
Authors: Natali A. , Vichi S. , Landi P. , Toschi E. , Severi S. , L’Abbate A. , Ferrannini E. 
Published: March 2003

Abstract. Natali A, Vichi S, Landi P, Toschi E, Severi S, L’Abbate A, Ferrannini E (C.N.R. Institute of Clinical Physiology and the University of Pisa, Pisa, Italy). Coronary artery disease and arterial hypertension: clinical, angiographic and follow‐up data. J Intern Med 2000; 247: 219–230.Objectives. To evaluate how the presence of arterial hypertension affects coronary atherosclerosis and prognosis in patients with, or at high risk of, ischaemic heart disease.Design. Retrospective analysis of clinical records and follow‐up data.Settings. Single referral centre for ischaemic heart disease.Subjects. All consecutive patients (n = 1700, 38% with hypertension) undergoing coronary angiography for the evaluation of ischaemic heart disease during 1983–92.Results. On angiography, the likelihood of having three‐vessel disease was higher amongst hypertensives (odds ratio = 1.41; 95% confidence interval [CI] = 1.08–1.85) after adjustment for age, sex, and angina symptoms. The sum of all visible stenoses (an index of overall atherosclerotic involvement) was 19% higher in hypertensives (262 ± 204 vs. 220 ± 194 units, P < 0.005). By multivariate analysis, the presence of hypertension made a modest (+ 28 units), albeit statistically significant, independent contribution to the total atherosclerosis score. On follow‐up (median = 96 months), cardiovascular mortality was slightly higher in the hypertensive patients than in the normotensive group (P < 0.05 in a Kaplan–Meier analysis), but a proportional hazard analysis adjusting for age and gender showed no significant independent contribution of hypertension. Hypertensive patients, however, remained at higher risk of non‐fatal myocardial infarction following discharge (adjusted odds ratio = 1.21, 95% CI = 1.03–1.46; P < 0.05).Conclusions. In this referral population, hypertension is a risk factor for presence of three‐vessel disease. Distribution, severity and extension of coronary stenosis are similar to those of normotensive patients, and prognosis is only marginally affected.
Impaired leukotriene C4 generation in granulocytes from protein‐energy malnourished chronically ill elderly
Authors: Cederholm T. , Lindgren J. Å. , Palmblad J. 
Published: March 2003

Abstract. Cederholm T, Lindgren JÅ, Palmblad J (Centre for Hematology and Inflammatory Research, Huddinge University Hospital and Karolinska Institutet, Stockholm, Sweden). Impaired leukotriene C4 generation in granulocytes from protein‐energy malnourished chronically ill elderly. J Intern Med 2000; 247: 715–722.Objective. The dysregulation of the immune and inflammatory systems observed in protein‐energy malnutrition (PEM) may be partly due to perturbation of essential fatty acid metabolism. In this study, we assessed the calcium ionophore A23187‐induced generation of the arachidonate metabolites leukotriene B4 (LTB4) and leukotriene C4 (LTC4) in isolated granulocyte suspensions.Design. Case–control study.Setting. A university‐affiliated acute care hospital in urban Stockholm.Subjects. Fourteen severely malnourished elderly subjects with stable non‐malignant disorders (age 74 ± 1 years, mean ± SEM) and 12 healthy age‐matched controls were examined.Main outcome measures. Leukotrienes were analysed by high‐performance liquid chromatography. Body mass index (BMI, kg m–2) and delayed cutaneous hypersensitivity (DCH) reaction were determined.Results. BMI was 16.5 ± 0.5 and 26.2 ± 0.9 kg m–2 (mean ± SE) in the malnourished group and controls (P < 0.001), respectively. DCH was 8.5 mm (median) in patients and 29.5 mm in controls (P < 0.001). LTC4 generation in granulocytes from PEM patients was half of that of controls (9.1 ± 2.0 vs. 17.8 ± 5.2 pmol mL–1, P < 0.05) when cells were stimulated with 0.2 µmol L–1 of A23187, and 13.7 ± 2.5 and 27.2 ± 7.5 pmol mL–1, respectively (NS), upon stimulation with 1.0 µmol L–1 of A23187. LTB4 production in PEM patients and controls did not differ at any of the two calcium ionophore concentrations. LTC4 production correlated with BMI (r = 0.41, P < 0.05), but there was no significant correlation between DCH and LTB4 or LTC4 production.Conclusion. Protein‐energy malnutrition is accompanied by perturbation of leukotriene synthesis, which may be one factor underlying the dysregulation of inflammatory responses in the depleted patient.
LDL particle size in relation to intima‐media thickness and plaque occurrence in the carotid and femoral arteries in patients with hypercholesterolaemia
Authors: Hulthe J. , Wiklund O. , Bondjers G. , Wikstrand J. 
Published: March 2003

Abstract. Hulthe J, Wiklund O, Bondjers G, Wikstrand J (Sahlgrenska University Hospital, Göteborg University, Gothenburg, Sweden). LDL particle size in relation to intima‐media thickness and plaque occurrence in the carotid and femoral arteries in patients with hypercholesterolaemia. J Intern Med 2000; 248: 42–52.Objectives. Small LDL particle size has been shown to be associated with coronary artery disease. However, no previous study has been performed relating LDL particle size to ultrasound measurement of atherosclerosis in hypercholesterolaemic subjects. The main aims of the present study were therefore: (i) to investigate the relationship between intima‐media thickness (IMT) of the carotid bulb and LDL particle size in patients with primary hypercholesterolaemia (n = 102) and in matched normocholesterolaemic controls (n = 102); and (ii) to investigate the relationship between plaque occurrence in the carotid and femoral arteries and LDL particle size. LDL particle size was determined by subjecting serum to 2–16% polyacrylamide gradient gel electrophoresis.Results. The results showed that patients with primary hypercholesterolaemia had smaller LDL peak particle size compared with healthy control subjects (P < 0.001 for men, P = 0.006 for women). However, the difference in LDL peak particle size between patients with hypercholesterolaemia and controls disappeared when adjusting for serum triglycerides. There was no association between increasing IMT of the carotid bulb and decreasing LDL peak particle size or between the occurrence of moderate to large plaques in the carotid and femoral arteries and small LDL peak particle size. However, metabolic variables such as serum triglycerides, HDL, blood glucose, body mass index, and also systolic blood pressure were associated with LDL peak particle size.Conclusion. The lack of an association between atherosclerosis, as measured by ultrasound, and small LDL particle size in patients with hypercholesterolaemia implies that other risk factors, such as hypercholesterolaemia and high blood pressure, may overshadow any importance of small LDL particle size.
Increased bone mineral density in a population‐based group of 70‐year‐old women on thiazide diuretics, independent of parathyroid hormone levels
Authors: Sigurdsson G. , Franzson L. 
Published: March 2003

Sigurdsson G, Franzson L (University Hospital, Fossvogur, Reykjavik, Iceland). Increased bone mineral density in a population‐based group of 70‐year‐old women on thiazide diuretics, independent of parathyroid hormone levels (Original Article). J Intern Med 2001; 250: 51–56. Background. Several studies have shown greater bone mineral density (BMD) in people receiving thiazide diuretics compared with controls. Most researchers have related this association to the hypocalciuric effect of thiazides with subsequent rise in serum calcium and fall in parathyroid hormone (PTH) levels. Recent experimental evidence suggests, however, a direct effect of thiazides on osteoblast‐like cells. Objective. To test the hypothesis that the association of thiazides and raised BMD is independent of PTH levels in humans. Subjects. A population‐based group of 248 70‐year‐old Icelandic women, 51 receiving thiazide diuretics, 39 receiving other antihypertensive therapy and the rest acting as controls. Main outcome measures. The independent contribution of thiazide usage and PTH to BMD in a multivariate analysis. Results. The mean BMD was 9.6% greater in the lumbar spine (P < 0.01) and 5.4% greater in the whole skeleton (P < 0.01) amongst thiazide users than in controls, reduced to 7.6% (P < 0.02) and 4.5% (P < 0.01), respectively, when corrected for fat mass which was 5.8 kg greater in the thiazide group. In a multivariate analysis, corrected for body weight and body composition, serum calcium and ln‐PTH, thiazides remained a significant independent predictor of BMD in the total skeleton and lumbar spine, but not in the total hip or femoral neck. Thiazides explained about 3% of the variability in whole body and lumbar spine BMD. Conclusions. Thiazides augment or preserve BMD independent of PTH, implying other mechanisms.
Episodes of ST‐segment depression is related to changes in ambulatory blood pressure and heart rate in intermittent claudication
Authors: Svensson P. , Niklasson U. , Östergren J. 
Published: March 2003

Abstract. Svensson P, Niklasson U, Östergren J (Karolinska Hospital, Stockholm, Sweden). Episodes of ST‐segment depression is related to changes in ambulatory blood pressure and heart rate in intermittent claudication. J Intern Med 2001; 250: 398–405. Objective. To study the prevalence and circadian distribution of ischaemic ST‐segment depression detected with ambulatory electrocardiographic monitoring (AECG) in patients with intermittent claudication (IC) as well as to study ambulatory blood pressure (ABP) and the relation of ischaemic episodes to variations in ABP and heart rate. Design. A total of 40 patients with a history of IC and an ankle/brachial‐index (ABI) <0.9 performed: (i) 24‐h AECG recordings, (ii) simultaneous 24 h recordings of ABP every 15 min (Spacelabs 90207), (iii) an exercise treadmill test (ETT). An ischaemic episode was defined as a transient ischaemic ST‐segment deviation ≥1 mm lasting >1 min. Eleven patients were excluded from ECG analysis because of uninterpretable ECG caused by treatment with digoxin or technical problems. Results. Out of 29 patients, eight experienced a total of 15 episodes of ST‐depression on AECG. The mean duration was 21 ± 31 min. The majority of episodes (11 of 15) occurred between 6 and 12 a.m. In eight patients with ST‐segment depression three had a history of ischaemic heart disease (IHD), four were hypertensives and four had signs of myocardial ischaemia on ETT. There were no significant differences between patients with and without ST‐segment depression in ABP, walking performance or ABI. During ST‐depression episodes systolic and diastolic blood pressure and heart rate were higher than day mean values; 178 ± 41 vs. 166 ± 30 mmHg (P=0.09); 96 ± 9 vs. 90 ± 4 mmHg (P=0.01) and 103 ± 9 vs. 87 ± 5 beats min–1 (P < 0.01). Conclusion. Silent myocardial ischemia occurred in about a third of patients with IC. Episodes of ischaemia were associated with an increased ABP and heart rate. Whether treatment of high blood pressure may reduce silent ischaemia and if this favourably influences outcome is a matter of further research.
Urinary albumin excretion is independently associated with C‐reactive protein levels in overweight and obese nondiabetic premenopausal women
Authors: Pannacciulli N. , Cantatore F. P. , Minenna A. , Bellacicco M. , Giorgino R. , De Pergola G. 
Published: March 2003

Abstract. Pannacciulli N, Cantatore FP, Minenna A, Bellacicco M, Giorgino R, De Pergola G (Section of Internal Medicine, Endocrinology and Metabolic Diseases and Section of Rheumatology, University of Bari, Bari, Italy). Urinary albumin excretion is independently associated with C‐reactive protein levels in overweight and obese nondiabetic premenopausal women. J Intern Med 2001; 250: 502–507. Objectives. C‐reactive protein (CRP) and microalbuminuria are nowadays considered markers of chronic inflammation of the arterial wall and of endothelial dysfunction, respectively. An increase of CRP levels and of urinary albumin excretion (UAE) rate have both been reported to be independently associated with a higher risk of cardiovascular morbidity and mortality in the general population. The aim of the present study was to evaluate the possible correlation between UAE and CRP concentrations in overweight and obese premenopausal women. Design and setting. A cross‐sectional study in a primary care setting. Subjects, main outcome measures. CRP levels and UAE rate were measured in 103 overweight and obese premenopausal women, aged 18–45 years. Other measurements included: central fat accumulation, as evaluated by waist circumference; insulin resistance, as calculated by homeostatic model assessment (HOMAIR); fat‐free mass (FFM), as measured by bioimpedance analysis; blood pressure; and fasting plasma levels of glucose, insulin, and lipids. Results. Urinary albumin excretion was positively correlated with body mass index (BMI) (P < 0.01), waist circumference (P < 0.001), diastolic blood pressure (P < 0.01), triglycerides (P < 0.01), HOMAIR (P < 0.05), and CRP levels (P < 0.05); and negatively associated with HDL cholesterol (P < 0.001). After multivariate analysis, diastolic blood pressure, HDL cholesterol, and CRP levels maintained their significant correlation with UAE. Conclusion. Our study shows a strong relationship between UAE and CRP concentrations, irrespective of age and other anthropometric and metabolic variables. On this basis, it can be argued that inflammation of the arterial wall, as indicated by higher CRP plasma levels, and endothelial dysfunction, as shown by higher UAE rate, might represent simultaneous phenomena in the development of atherosclerosis in overweight and obese premenopausal women.
Haemochromatosis: Understanding the mechanism of disease and implications for diagnosis and patient management following the recent cloning of novel genes involved in iron metabolism
Authors: Fletcher L. M. , Halliday J. W. 
Published: March 2003

Abstract. Fletcher LM, Halliday JW (The Princess Alexandra Hospital; and The Queensland Institute of Medical Research, Queensland, Australia). Haemochromatosis: understanding the mechanism of disease and implications for diagnosis and patient management following the recent cloning of novel genes involved in iron metabolism (Review). J Intern Med 2002; 251: 181–192.Haemochromatosis, a common recessive genetic disorder in people of Northern European descent, is an iron storage disorder characterized by excessive hepatic iron accumulation resulting from disruption of the regulation of intestinal iron absorption. The identification of novel genes involved in the control of iron absorption from the diet has allowed improved understanding of iron metabolism in health and disease. In particular, the identification of the haemochromatosis gene (HFE) and more recently the transferrin receptor 2 gene (TfR2) together with the specific mutations in these genes which result in hepatic iron overload, has enhanced our understanding of the pathophysiology of haemochromatosis. However, because of the wide variation in phenotypic expression of the disease, there now exists a considerable challenge to diagnosis and patient management.
Angiotensin‐converting enzyme gene polymorphism in relation to HLA‐DR in sarcoidosis
Authors: Planck A. , Eklund A. , Yamaguchi E. , Grunewald J. 
Published: March 2003

Abstract. Planck A, Eklund A, Yamaguchi E, Grunewald J. (Karolinska Hospital, Stockholm, Sweden; and Hokkaido University School of Medicine, Sapporo, Japan). Angiotensin‐converting enzyme gene polymorphism in relation to HLA‐DR in sarcoidosis. J Intern Med 2002; 251: 217–222. Objectives. To investigate if an insertion/deletion (I/D) polymorphism in the angiotensin‐converting enzyme (ACE) gene associates with HLA‐DR alleles previously found to be of prognostic interest in Scandinavian sarcoidosis patients. This may contribute to characteristics associated with these HLA‐DR alleles, such as a good (DR17) or poor (DR14 or 15) prognosis. Design, settings and subjects. Polymerase chain reaction (PCR) was used for analysing an I/D polymorphism in the gene coding for ACE in 138 subjects; 65 controls and 73 sarcoidosis patients, and for HLA‐DR genotyping 67 patients. Serum ACE level (S‐ACE) was measured in all controls and 72 patients. Sixty‐one patients were classified as chronic or nonchronic after 2 years follow‐up. All patients were recruited and followed at our outpatient clinic. Results. No significant differences in ACE alleles or genotypes were seen between controls and patients or between patients positive and negative for DR17 or DR14/15. The ACE genotype did not differ between nonchronic and chronic patients. The ACE genotype tended to influence the S‐ACE in patients, whilst in controls S‐ACE significantly differed between the ACE genotypes. Conclusion. This study does not support an association between ACE genotype and sarcoidosis or disease outcome. However, because significantly (P < 0.001) more DR17 positive (17 of 19) than DR14/15 positive (seven of 26) patients were classified as nonchronic, these results instead strengthen the prognostic importance of HLA‐DR alleles in Scandinavian sarcoidosis patients.
Perioperative myocardial infarction in noncardiac surgery: the diagnostic and prognostic role of cardiac troponins
Authors: LUCREZIOTTI S. , FORONI C. , FIORENTINI C. 
Published: March 2003

Abstract. Lucreziotti S, Foroni C, Fiorentini C (Università degli Studi di Milano, Ospedale S. Pado, Milano, Italy). Perioperative myocardial infarction in noncardiac surgery: the diagnostic and prognostic role of cardiac troponins (Review). J Intern Med 2002; 252: 11–20.Despite the number of technologies used, the diagnosis of perioperative myocardial infarction is still a challenge. Studies conducted in surgical series have demonstrated that cardiac troponins (cTns) have both a superior diagnostic sensitivity and specificity, compared with other traditional techniques, and an independent power to predict short‐ and long‐term prognosis. Nevertheless, some points need to be clarified. They include the usefulness of cTns in patients with end‐stage renal failure; the standardization of the cTns cut‐off for the diagnosis of myocardial injury; the timing of postoperative blood samplings; the cost‐effectiveness of a screening in asymptomatic patients; and the possible therapeutic strategies.
Vitamin B‐12 treatment has limited effect on health‐related quality of life among individuals with elevated plasma methylmalonic acid: a randomized placebo‐controlled study
Authors: Hvas A.‐M. , Juul S. , Nexø E. , Ellegaard J. 
Published: March 2003

Abstract.  Hvas A‐M, Juul S, Nexø E, Ellegaard J (Aarhus University Hospital, Aarhus, Denmark). Vitamin B‐12 treatment has limited effect on health‐related quality of life among individuals with elevated plasma methylmalonic acid: a randomized placebo‐controlled study. J Intern Med 2003; 253: 146–152.Objective.  To examine the hypothesis that treatment with vitamin B‐12 improves health‐related quality of life (HRQOL) in individuals with biochemical signs of vitamin B‐12 deficiency.Design.  A randomized placebo‐controlled study.Setting.  Municipality of Aarhus, Denmark.Subjects.  Nonhospitalized individuals (n = 140) with a modest increase in plasma methylmalonic acid (0.40–2.00 μmol L−1) not previously treated with vitamin B‐12.Intervention.  The participants were randomized to vitamin B‐12 injection treatment or placebo weekly for 4 weeks and re‐examined 3 months later. The investigator and the participants were blinded to the intervention.Main outcome measure.  Change in HRQOL assessed by the SF‐36 questionnaire from baseline to follow‐up examination 3 months later.Results.  The participants reported a significantly worser HRQOL than the age‐ and sex‐matched Danish general population (P < 0.001). However, no change was observed after treatment with vitamin B‐12 for seven of eight health dimensions. A significant improvement was found only in general health when compared with the placebo group (P = 0.03).Conclusions.  Vitamin B‐12 treatment influenced only one of eight dimensions of HRQOL amongst participants with biochemical signs of vitamin B‐12 deficiency. We therefore question the benefit of vitamin B‐12 treatment amongst elderly with a modestly increased plasma methylmalonic acid as the only sign of vitamin B‐12 deficiency.
Mortality amongst participants in Vasaloppet: a classical long‐distance ski race in Sweden
Authors: Farahmand B. Y. , Ahlbom A. , Ekblom Ö. , Ekblom B. , Hållmarker U. , Aronson D. , Brobert G. Persson 
Published: March 2003

Abstract. Farahmand BY, Ahlbom A, Ekblom Ö, Ekblom B, Hållmarker U, Aronson D, Persson Brobert G (Stockholm Center of Public Health, and Institute of Environmental Medicine; Institute of Physiology and Pharmacology, Karolinska Institutet, Stockholm; Mora Hospital; and Astrazeneca R&D, Södertälje; Sweden). Mortality amongst participants in Vasaloppet: a classical long‐distance ski race in Sweden. J Intern Med 2003; 253: 276–283.Objective. The aim of this study was to assess mortality amongst participants in long‐distance ski races during the Vasaloppet week. We considered the 90 km races for men and 90 or 30 km for women. The vast majority of the participants in these races are not competing on the elite level. It is assumed, however, that they have to undergo regular physical training during a long period of time in order to successfully finish the race.Design. The cohort study consisted of 49 219 men and 24 403 women, who participated in any of the races during 1989–1998. All subjects were followed up in the National‐Cause‐of‐Death‐Register until 31 December 1999. We computed the standardized mortality ratios (SMRs) adjusting for age and calendar year.Results. Overall, 410 deaths occurred, compared with 850.6 expected, yielding an SMR of 0.48 [95% confidence interval (CI) 0.44–0.53]. Low SMRs were found in all age groups in both men and women and in all groups after categorization by finishing time and number of races. The lowest SMRs were found amongst older participants and in those who participated in several races. A decreased mortality was observed in all major diagnostic groups, namely cancers (SMR = 0.61; 95% CI 0.52–0.71), diseases of the circulatory system (SMR = 0.43; 95% CI 0.35–0.51), and injuries and poisoning (SMR =0.73; 95% CI 0.60–0.89). For lung cancer the SMR was 0.22, but even after exclusion of lung cancer the all‐cancer mortality was low (SMR = 0.72; 95% CI 0.59–0.86).Conclusions. We conclude that participants in long‐distance skiing races, which demand prolonged regular physical training, have low mortality. The extent to which this is due to physical activity, related lifestyle factors, genetics or selection bias is yet to be assessed.