bluuebunny/crossref_metadata_2025_split huggingface dataset:
Renal symptomatology in patients with acute intermittent porphyria. A population‐based study
Authors: Andersson C. , Wikberg A. , Stegmayr B. , Lithner F. 
Published: March 2003

Abstract. Andersson C, Wikberg A, Stegmayr B, Lithner F (University Hospital, Umeå, Sweden). Renal symptomatology in patients with acute intermittent porphyria. A population‐based study. J Intern Med 2000; 248: 319–325.Objective. Can renal insufficiency in subjects with acute intermittent porphyria (AIP) be due solely to AIP?Design. A population‐based study.Subjects. Subjects with AIP ≥ 18 years of age (n = 386) in the four most northerly counties of Sweden.Interventions. Screening with creatinine clearance at 24 h. Patients below the lower reference level underwent a repeat clearance test and, if still low, also chromEDTA clearance.Results. 286 (74%) subjects performed the creatinine clearance test and in 57 clearance was low; the second clearance proved normal in 23 who were then excluded. Eighteen subjects with other possible medical reasons for renal insufficiency, ethical reasons or refusing further examinations were also excluded. The 16 remaining subjects with no explanation for their renal insufficiency other than AIP were then studied in detail. All 14 women, mean age 52 years, and two uraemic men, 58 and 67 years, had manifest AIP. Twelve patients had hypertension (HT) and four were normotensive in spite of renal insufficiency. Histological findings of renal biopsies revealed diffuse glomerulosclerotic and interstitial changes with additional ischaemic lesions.Conclusion. Protracted vasospasm in attacks of AIP may be a cause of renal lesions. This is discussed.
Liver fibrosis attributed to lipid lowering medications: two cases
Authors: Punthakee Z. , Scully L. J. , Guindi M. M. , Ooi T. C. 
Published: March 2003

Abstract. Punthakee Z, Scully LJ, Guindi MM, Ooi TC (Department of Medicine, Division of Gastroenterology, Department of Pathology and the Laboratory of Medicine and the Division of Endocrinology and Metabolism, The Ottawa Hospital – Civic Campus, University of Ottawa, Ottawa, Canada). Liver fibrosis attributed to lipid lowering medications: two cases (Case Report). J Intern Med 2001; 250: 249–254.We identified two cases of chronic active hepatitis with liver fibrosis induced by lipid lowering drugs of the statin and fibrate classes despite regular monitoring of transaminases. There are few reports of clinically significant hepatitis induced by these drugs and even fewer cases of fibrosis. Given the growing use of these drugs, there are implications for monitoring patients on long‐term therapy for liver damage.
Effect of second and third generation oral contraceptives on lipid metabolism in the absence or presence of the factor V Leiden mutation
Authors: Kemmeren J. M. , Algra A. , Grobbee D. E. 
Published: March 2003

Abstract. Kemmeren JM, Algra A, Grobbee DE (University Medical Center Utrecht, Utrecht, The Netherlands). Effect of second and third generation oral contraceptives on lipid metabolism in the absence or presence of the factor V Leiden mutation. J Intern Med 2001; 250: 441–448. Objectives. The effect of a second and third generation oral contraceptive and of the progestagens used in these pills on lipid metabolism was studied in the absence or presence of the factor V Leiden mutation. Design. A single centre, double blind randomized trial. Setting. University Medical Centre. Subjects. A total of 51 women without and 35 women with the factor V Leiden mutation. Interventions. A second generation (30 μg ethinylestradiol/150 μg levonorgestrel) or a third generation (30 μg ethinylestradiol/150 μg desogestrel) oral contraceptive. After two cycles of use and a wash‐out period of two cycles, the participants received the corresponding progestagen‐only preparation containing 150 μg levonorgestrel or 150 μg desogestrel. Main outcome measures. Mean difference in changes between the treatment groups on total cholesterol, HDL, LDL, triglycerides and total/HDL cholesterol ratio. Results. Compared with levonorgestrel, desogestrel‐containing oral contraceptives caused in women without the factor V Leiden mutation significant changes in HDL (0.43; 95% confidence interval [CI] 0.25–0.61), LDL (–0.55; 95% CI –0.90 to –0.20), triglycerides (0.19; 95% CI 0.06–0.32) and total/HDL cholesterol ratio (–0.87; 95% CI –1.21 to –0.53). When the progestagen‐only preparations were used, differential changes were found for HDL (0.16; 95% CI 0.03–0.29), LDL (–0.31; 95% CI –0.56 to –0.05) and total/HDL cholesterol ratio (−0.55; 95% CI –0.84 to –0.26). Desogestrel‐only caused changes opposite to those of desogestrel‐containing oral contraceptives. For cholesterol and triglycerides, this effect was also found for levonorgestrel‐only in comparison with levonorgestrel‐combined oral contraceptives. Levonorgestrel appeared to induce the effect on HDL. Almost all results were similar for women with the factor V Leiden mutation. Conclusion. It appears that desogestrel counteracts the effects of oestrogens to a lesser extent than levonorgestrel. Desogestrel‐containing oral contraceptives have therefore a more favourable influence on cholesterol metabolism in comparison with levonorgestrel‐containing oral contraceptives.
Relationship between anti‐neutrophil cytoplasmic antibody determined with conventional binding and the capture assay, and long‐term clinical course in vasculitis
Authors: Gisslén K. , Wieslander J. , Westberg G. , Herlitz H. 
Published: March 2003

Gisslén K, Wieslander J, Westberg G, Herlitz H (Sahlgrenska University Hospital, Göteborg; and Wieslab AB, Lund; Sweden). Relationship between anti‐neutrophil cytoplasmic antibody (ANCA) determined with conventional binding and the capture assay, and long‐term clinical course in vasculitis. J Intern Med 2002; 251: 129–135. Objectives. To evaluate the relationship between anti‐neutrophil cytoplasmic antibody (ANCA) measured with two different methods and long‐term clinical course in vasculitis. Design. Retrospective determination of ANCA with two different assays for detection of PR3‐ANCA, conventional direct binding ELISA and capture ELISA using monoclonal antibodies against PR3. The 245 ANCA determinations were performed from frozen blood samples collected three to four times a year in each patient. Setting. Department of Nephrology at a Swedish University Hospital. Subjects. A total of 10 ANCA‐positive patients with vasculitis caused by Wegener’s granulomatosis (WG) or microscopic polyarteritis (MPA) and a very long follow‐up time (mean 9 years, range 5–15.5 years). Results. The total number of episodes with active vasculitis was 29 and all of them (100%) were detected by the capture technique whilst the conventional technique detected 23 (79%). The mean number of episodes with active disease requiring treatment with steroids and cytotoxic drugs was three per patient (range 1–6). At the time of clinical relapse of the vasculitis disease, the ANCA titre using the capture technique was either increasing or showed a very high value in all cases. The pattern of capture ANCA response could be subdivided into three categories: a close (four patients), an intermediate (three patients), and no (three patients) relationship between capture ANCA level and long‐term clinical course. Conclusion. Detection of PR3‐ANCA by the capture ELISA showed a higher sensitivity than that obtained by the direct ELISA in diagnosing relapse during follow‐up of patients with vasculitis. The specificity of the capture ANCA was, however, low, as high levels occurred in patients without clinical disease activity.
Chlamydia pneumoniae IgA‐ and IgG antibodies in young survivors of myocardial infarction. A comparison of antibody detection by a microimmunofluorescence test and an enzyme immunoassay
Authors: Halvorsen D. S. , Børvik T. , Njølstad I. , Gutteberg T. J. , Vorland L. H. , Hansen J.‐B. 
Published: March 2003

Abstract. Halvorsen DS, Børvik T, Njølstad I, Gutteberg TJ, Vorland LH, Hansen J‐B (University Hospital of Tromsø; and Institute of Community Medicine, Tromsø, Norway). Chlamydia pneumoniae IgA‐ and IgG antibodies in young survivors of myocardial infarction. A comparison of antibody detection by a microimmunofluorescence (MIF) test and an enzyme immunoassay (EIA). J Intern Med 2002; 251: 142–147. Objectives. Chronic Chlamydia pneumoniae infection is considered as a cardiovascular risk factor and antibodies are commonly analysed by the subjective microimmunofluorescence (MIF) test. We wanted to investigate the C. pneumoniae IgA‐ and IgG seroprevalence in young survivors of myocardial infarction and matched controls, and to compare the agreement of detecting antibodies between a MIF test and an enzyme immunoassay (EIA). Design. A total of 61 patients hospitalized as a result of myocardial infarction, 51 patients hospitalized with chest pain and negative exercise‐ECG and 61 age and sex matched controls (mean age 53.3 years, range 40–60 years) were included in this case–control study. Serological comparisons were expressed as sensitivity, specificity and interrater agreement (K or Kw) of the EIA test related to the MIF test. Results. Presence of IgA (cut off=16) antibodies was significantly higher in coronary heart patients compared with controls for both assays (P=0.02 by the MIF and P=0.05 by the EIA test). The presence of IgG (cut off=32) antibodies was significantly higher amongst patients (P=0.05) when analysed by the MIF‐test, but not with the EIA‐test (P=0.16). The strength of agreement between the assays was good for both IgA‐ (Kw=0.67) and IgG (Kw=0.79) analyses. However, only 52.8% of the IgA samples classified as strong positive (cut‐off=32) by the MIF test were strong positive by the EIA test (K=0.56). Only 73.2% of the negative IgG samples (<32) by the MIF‐test turned out negative by the EIA‐test (K=0.73). Conclusions. Dependent on assay and cut‐off level, there is an increased C. pneumoniae IgA‐ and IgG seroprevalence in young survivors of myocardial infarction compared with controls. Despite the subjective interpretation of MIF‐titres, the strength of agreement between the EIA and MIF tests was good for both antibody classes. However, misclassification of highly positive IgA samples and negative IgG samples by the MIF test may influence study conclusions. We conclude that the choice of serological method is of major importance when evaluating a possible relationship between C. pneumoniae and coronary heart disease.
The effect of tibolone on the lipoprotein profile of postmenopausal women with type III hyperlipoproteinemia
Authors: De Beer F. , Smelt A. H. M. , Van Vark L. C. , Hoogerbrugge N. , Havekes L. M. , Gevers Leuven J. A. 
Published: March 2003

Abstract. de Beer F, Smelt AHM, van Vark LC, Hoogerbrugge N, Havekes LM, Gevers Leuven JA (Gaubius Laboratory, Leiden; Leiden University Medical Center, Leiden; and University Hospital Dijkzigt, Rotterdam, The Netherlands). The effect of tibolone on the lipoprotein profile of postmenopausal women with type III hyperlipoproteinemia. J Intern Med 2002; 251: 148–155. Objective. To investigate the short‐term effect of treatment with tibolone on plasma lipid and lipoprotein levels in postmenopausal women with type III hyperlipoproteinemia (HLP). Design and intervention. Patients were randomized to receive, in a double‐blind cross‐over fashion, a fixed dose of tibolone, 2.5 mg once daily or placebo for 8 weeks. The two treatment periods were separated by a wash‐out period of 6 weeks. At each visit body weight and blood pressure were determined. Before and after each treatment period, fasting venous blood samples were obtained from the patients for biochemical measurements. Setting. The Leiden University Medical Center. Subjects. Postmenopausal women with type III HLP (aged ≤65 years) were recruited from the Lipid Clinics of the Leiden University Medical Center, the Amsterdam Medical Center, the Utrecht Medical Center and the University Hospital Rotterdam. Five out of 25 women with type III HLP were eligible to be included in the study. Four of the five included patients completed the study according to the protocol. One patient was excluded from blinded therapy because total cholesterol levels increased above 20 mmol L–1. Main outcome measures. A significant reduction of plasma triglyceride, total cholesterol, VLDL cholesterol and VLDL triglyceride levels. Results. Plasma triglyceride and total cholesterol levels decreased from 6.82 ± 3.58 to 2.45 ± 1.36 mmol L–1 and from 13.53 ± 3.64 to 6.61 ± 2.03 mmol L–1, respectively (both P < 0.05). The body mass index remained unchanged. The glycated haemoglobin percentage decreased significantly from 5.8 to 5.3%. Treatment with tibolone resulted in a profound reduction in plasma apolipoprotein E, VLDL cholesterol and VLDL triglyceride levels (mean reductions of 66, 77 and 70%, respectively, P < 0.05). Conclusions. Tibolone is a valuable adjuvant to current therapy in postmenopausal women with type III HLP.
Body position and blood pressure measurement in patients with diabetes mellitus
Authors: NETEA R. T. , ELVING L. D. , LUTTERMAN J. A. , THIEN TH. 
Published: March 2003

Abstract. Netea RT, Elving LD, Lutterman JA, Thien Th (University Medical Center, The Netherlands). Body position and blood pressure measurement in patients with diabetes mellitus. J Intern Med 2002; 251: 393–399. Aims. World Health Organization (WHO) guidelines recommend that the blood pressure (BP) should be routinely measured in sitting or supine followed by standing position, providing that the arm of the patient is placed at the level of the right atrium in each position. The aim of our study was to test the influence of body and arm position on BP measurement in diabetic patients. Methods. In 142 patients with diabetes mellitus the BP was measured using a semiautomatic oscillometric device (Bosomat‐R): (i) after 5 min of rest sitting on a chair with one arm supported at the right atrial level and with the other arm placed on the arm support of the chair, (ii) after 5 min of rest lying on a bed with both arms placed on a bed, and (iii) after 30 s and after 2 min of standing with one arm (the same as in sitting position) supported at the right atrial level and with the other arm vertical, parallel to the body. Results. Both systolic (SBP) and diastolic (DBP) blood pressures were significantly lower in sitting position with the arm at the right atrial level than in supine position (by 7.4 and 6.6 mmHg, respectively, P < 0.01). In sitting and standing positions, SBP and DBP were higher when the arm was placed either on the arm support of the chair or vertical, parallel to the body, than when the arm was supported at the level of the right atrium (by 6–10 mmHg, P < 0.001). Duration of standing did not influence the estimation of orthostatic hypotension. Conclusions. The data of this study indicate that the WHO recommendation with regard to the equivalence of sitting and supine BP readings is incorrect at least in diabetic patients, as the sitting BP is lower than the supine BP when the arm was positioned at the right atrial level. In addition, incorrect positioning of the arm in standing position results in an underestimation of prevalence of orthostatic hypotension. We conclude that during BP measurement the arm should be placed at the right atrial level regardless of the body position.
Ten‐year mortality for patients discharged after hospitalization for chest pain or other symptoms raising suspicion of acute myocardial infarction in relation to hospital discharge diagnosis
Authors: Herlitz J. , Karlson B. W. , Sjölin M. , Lindquist J. 
Published: March 2003

Abstract. Herlitz J, Karlson BW, Sjölin M, Lindqvist J (Sahlgrenska University Hospital, Göteborg, Sweden). Ten‐year mortality for patients discharged after hospitalization for chest pain or other symptoms raising suspicion of acute myocardial infarction in relation to hospital discharge diagnosis. J Intern Med 2002; 251: 526–532. Aim. To describe the 10‐year prognosis for patients discharged after hospitalization for chest pain or other symptoms giving an initial suspicion of acute myocardial infarction (AMI) in relation to the final hospital diagnosis and furthermore to compare the outcome amongst these patients with the outcome amongst a sex‐, age‐ and community‐matched con‐ trol population. Methods. All patients who were hospitalized because of chest pain or other symptoms raising a suspicion of AMI and who were discharged alive from hospital. Patients were divided into three groups according to the final diagnosis: (1) confirmed or possible AMI, (2) confirmed or possible myocardial ischaemia and (3) other aetiology. Information on 10‐year mortality was available in 3103 patients. A sex‐, age‐ and community‐matched control population (n=3221) was compared with the study population in terms of 10‐year mortality. Time of the survey. 15 February 1986 to 9 November 1987. Setting. Sahlgrenska University Hospital. Results. Patients with confirmed or possible AMI (n=849) had a significantly higher mortality (59.4%) than patients with confirmed or possible myocardial ischaemia (n=1191) who had a mortality of 49.5% (P < 0.0001). The latter group had a higher mortality than patients with `other aetiology' (n=1063) of whom 40.6% died (P < 0.0001). When comparing the prognosis for patients with AMI and myocardial ischaemia, there was a significant interaction with sex, with a more marked difference in women than in men. Amongst all patients, the 10‐year mortality was 49.1 vs. 37.3% in the control group (P < 0.0001). Conclusion. The very long term prognosis was strongly associated with diagnosis amongst patients hospitalized and discharged alive because of chest pain or other symptoms raising suspicion of AMI. The absolute mortality difference between patients who were discharged from hospital with confirmed diagnosis of AMI and those whose symptoms were considered to have other aetiology than AMI or ischaemia was nearly 20%. However, the absolute mortality difference between the patients included in the survey and a control population was only 12%.
Rescue percutaneous transluminal coronary angioplasty in a patient with a single coronary artery arising from the right Sinus Valsalvae: previously unreported scenario and review of literature
Authors: ZWEIKER R. , LUHA O. , KLEIN W. W. 
Published: March 2003

Abstract. Zweiker R, Luha O, Klein WW (Karl‐Franzens University Hospital, Austria). Rescue percutaneous transluminal coronary angioplasty in a patient with a single coronary artery arising from the right Sinus Valsalvae: previously unreported scenario and review of literature (Case Report). J Intern Med 2002; 252: 84–87.This is the first description of treatment with coronary stenting of a patient with a single coronary artery originating from the right Sinus Valsalvae and suffering from acute inferior myocardial infarction. Angiography showed the following: the right coronary artery (RCA) had a normal course, whilst the left anterior descending (LAD) as well as the left circumflex (LCX) branches both originated separately from the proximal RCA, which served as a common mixed trunk. The LAD crossed to the left in front of the right ventricular outflow tract, whilst the LCX, taking a retroaortic course to the atrioventricular groove, had a distal occlusion. According to an anatomically based classification considering all imaginable variations, this configuration corresponds to a II‐D‐1 pattern, which previously has been described only in a single postmortem case. After the LCX was reopened with a guide wire, a coronary stent was successfully inserted, resulting in TIMI‐3 flow. Recovery was uneventful.
Insulin resistance is accompanied by increased von Willebrand factor levels in nondiabetic women: a study of offspring of type 2 diabetic subjects compared to offspring of nondiabetic subjects
Authors: Foss C. H. , Vestbo E. , FrØland A. , Ingerslev J. , Gjessing H. J. , Mogensen C. E. , Damsgaard E. M. 
Published: March 2003

Abstract. Foss CH, Vestbo E, frøland A, Ingerslev J, Gjessing HJ, Mogensen CE, Damsgaard EM (Aarhus University Hospital, Aarhus, Denmark; Fredericia Hospital Fredericia, Denmark). Insulin resistance is accompanied by increased von Willebrand factor levels in nondiabetic women: a study of offspring of type 2 diabetic subjects compared to offspring of nondiabetic subjects. J Intern Med 2002; 252: 155–163.Objectives.  To examine whether levels of von Willebrand factor (vWF), fibrinogen and fibronectin are related to a parental history of type 2 diabetes and to determine possible explanatory factors for high versus low vWF and fibrinogen.Design.  Cross‐sectional study.Subjects, main outcome measures.  We compared vWF, fibrinogen and fibronectin in 88 nondiabetic offspring of type 2 diabetic subjects (relatives) and 103 offspring of nondiabetic subjects (controls). Other measurements included urinary albumin excretion rate, blood pressure, lipid profile and insulin resistance using homostatis model assessment (HOMAIR).Results.  There were no significant differences in vWF (1.12 vs. 1.06 IU mL−1, P = 0.296), fibrinogen (3.2 vs. 3.1 g L−1; P = 0.263) or fibronectin (0.39 vs. 0.40 g L−1, P = 0.448) between relatives and controls. With multiple logistic regression we determined explanatory factors for high versus lowvWF and fibrinogen. Age (P < 0.01), urinary albumin excretion rate (P < 0.05), ischaemic heart disease (IHD) (P < 0.05) were found to be significant explanatory factors for vWF above the median (1.10 IU mL−1). Interaction between insulin resistance and sex was found. Odds ratio for high versus low insulin resistance was 18.39 (P < 0.001) for women and 1.92 (P = 0.32) for men. Body mass index (BMI) (P < 0.05), sex (P < 0.01), smoking status (P < 0.05) and IHD (P < 0.01) were significant explanatory factors for fibrinogen above the median (3.1 g L−1).Conclusions.  Levels of vWF, fibrinogen and fibronectin were not influenced by a parental history of type 2 diabetes. Insulin resistance was found to be a significant risk indicator for high vWF only in women. This may indicate that insulin resistance is a higher risk factor for women than for men, when the outcome is endothelial dysfunction possibly resulting in overt cardiovascular disease.