bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hepatitis C virus risk: a hepatitis C virus related syndrome
Authors: Mazzaro C. , Panarello G. , Tesio F. , Santini G. , Crovatto M. , Mazzi G. , Zorat F. , Tulissi P. , Pussini E. , Baracetti S. , Campanacci L. , Pozzato G. 
Published: March 2003

Abstract. Mazzaro C, Panarello G, Tesio F, Santini G, Crovatto M, Mazzi G, Zorat F, Tulissi P, Pussini E, Baracetti S, Campanacci L, Pozzato G (Pordenone General Hospital, Pordenone; University of Trieste, School of Medicine, Trieste, Italy). Hepatitis C virus risk: a hepatitis C virus‐related syndrome. J Intern Med 2000 247: 535–545.Background. The association between mixed cryoglobulinemia (MC) and hepatitis C virus (HCV) infection has been recently described in many reports.Objective. The aim of this study was to evaluate the long‐term prognosis of hepatitis C virus‐positive patients affected by mixed cryoglobulinemia with or without kidney involvement.Patients. At total of 119 hepatitis C virus‐positive patients affected by mixed cryoglobulinemia were divided in two groups. Group A: mixed cryoglobulinemia without kidney involvement (103 cases); group B: mixed cryoglobulinemia with glomerulonephritis (GN) (16 cases). A further 37 patients affected by mesangio‐proliferative glomerulonephritis (MPGN) were evaluated as controls (group C).Methods. Anti‐hepatitis C virus antibodies were determined by commercial kits and hepatitis C virus‐RNA was detected by polymerase chain reaction (PCR) amplification of the 5′ untranslated region (5′UTR) of the virus. The hepatitis C virus genotype was determined according to Okamoto. Liver biopsy was performed in 62 patients, bone marrow biopsy in 65 patients, and kidney biopsy in all patients with proteinuria.Results. In group A, 46 patients (45%) were affected by chronic liver disease (CLD), 21 (20%) by low‐grade non‐Hodgkin’s lymphoma (NHL) and 16 (15%) by both diseases. All patients of group B were affected by type I membrano‐proliferative glomerulonephritis, 3 (19%) by chronic liver disease, 6 (37%) by low‐grade non‐Hodgkin’s lymphoma, and 7 (44%) by both diseases. Several genotypes of hepatitis C virus were found, but Type 1b was prevalent. In group C, no patient showed chronic liver disease or non‐Hodgkin’s lymphoma. Younger age, higher mean blood pressure, lower C4 serum level, and poorer survival significantly distinguished group B from group A. Survival rates at 5 years were: 87.4% for group A, 89.5% for group C, and 50.0% for group B. None of the patients of group B developed kidney failure requiring dialysis, whilst infections were the leading cause of death.Conclusions. In hepatitis C virus‐positive patients, the presence of mixed cryoglobulinemia associated with kidney involvement seems to indicate a new syndrome characterized by immune system impairment, lack of progression to kidney failure, and poor survival (hepatitis C virus‐Risk syndrome).
The Q/E27 polymorphism in the β2‐adrenoceptor gene is associated with increased body weight and dyslipoproteinaemia involving triglyceride‐rich lipoproteins
Authors: Ehrenborg E. , Skogsberg J. , Ruotolo G. , Large V. , Eriksson P. , Arner P. , Hamsten A. 
Published: March 2003

Abstract. Ehrenborg E, Skogsberg J, Ruotolo G, Large V, Eriksson P, Arner P, Hamsten A (Karolinska Hospital, Stockholm, and Huddinge University Hospital, Huddinge, Sweden; and Istuto Scientifico H San Raffaele, Milano, Italy). The Q/E27 polymorphism in the β2‐adrenoceptor gene is associated with increased body weight and dyslipoproteinaemia involving triglyceride‐rich lipoproteins. J Intern Med 2000; 247: 651–656.Objectives. To investigate whether a substitution of glutamine by glutamic acid at amino acid position 27 (Q/E27) and an arginine to glycine transition at amino acid 16 (R/G16) in the β2‐adrenoceptor gene are associated with lipid and lipoprotein disturbances and/or increased body weight in men.Design. Population‐based study.Setting. Department of medicine at a university hospital.Subjects. A total of 180 healthy men, aged 30–45 years, were recruited at random from a register containing all permanent residents in Stockholm County (response rate of 70%).Main outcome measures. Frequency of β2‐adrenoceptor genotypes and alleles in relation to plasma lipid and lipoprotein levels and body mass index.Results. Individuals carrying the E27 allele and/or the G16 allele had significantly higher body mass index (BMI). Furthermore, carriers of the E27 allele had significantly higher plasma concentrations of cholesterol, triglycerides, VLDL cholesterol and VLDL triglycerides than did subjects homozygous for the Q allele.Conclusion. The E27 allele of the β2‐adrenoceptor gene is associated with slightly to moderately elevated BMI and dyslipoproteinaemia involving triglyceride‐rich lipoproteins in healthy younger and middle‐aged men.
Short stature and coronary heart disease: a 35‐year follow‐up of the Finnish cohorts of The Seven Countries Study
Authors: Forsén T. , Eriksson J. , Qiao Q. , Tervahauta M. , Nissinen A. , Tuomilehto J. 
Published: March 2003

Abstract. Forsén T, Eriksson J, Qiao Q, Tervahauta M, Nissinen A, Tuomilehto J (National Public Health Institute, Helsinki, and University of Kuopio, Kuopio, Finland). Short stature and coronary heart disease: a 35‐year follow‐up of the Finnish cohorts of The Seven Countries Study. J Intern Med 2000; 248: 326–332.Objectives. To examine whether short stature is associated with an increased risk of coronary heart disease.Design. Follow‐up study.Setting. Two geographically defined areas in eastern and western Finland.Subjects. A total of 1441 men who were free of coronary heart disease at the start of the follow‐up.Main outcome measures. Hazard ratios for fatal and non‐fatal coronary heart diseaseResults. Height was inversely related to fatal coronary heart disease and incident non‐fatal coronary heart disease during the follow‐up. These relationships persisted after adjusting for other major cardiovascular risk factors. Comparing the high‐risk area in eastern Finland with the low‐risk area in south‐western Finland, no difference in fatal coronary heart disease and cumulative incidence of non‐fatal coronary heart disease was seen in tall men. The increase in risk of coronary heart disease death was 19% for a 10 cm decrease in height (OR = 0.81, 95% CI = 0.68–0.95).Conclusions. Our results show that short stature is an independent risk factor for coronary heart disease. Differences in stature partly explain the Finnish east–west difference in the incidence of coronary heart disease.
Identification of a new coeliac disease subgroup: antiendomysial and anti‐transglutaminase antibodies of IgG class in the absence of selective IgA deficiency
Authors: Picarelli A. , Di Tola M. , Sabbatella L. , Mastracchio A. , Trecca A. , Gabrielli F. , Di Cello T. , Anania M. C. , Torsoli A. 
Published: March 2003

Abstract. Picarelli A, Di Tola M, Sabbatella L, Mastracchio A, Trecca A, Gabrielli F, Di Cello T, Anania MC, Torsoli A (University of Rome “La Sapienza”, Rome, Italy). Identification of a new coeliac disease subgroup: antiendomysial and anti‐transglutaminase antibodies of IgG class in the absence of selective IgA deficiency.J Intern Med2001;249:181–188.Objective. The aim of the present study was to increase the sensitivity of the antiendomysial antibody (EMA) test by evaluating also EMAs of IgG1 isotype.Design and subjects. Over the last 2 years, serum EMAs IgA and IgG1 were determined in 1399 patients, referred to our gastrointestinal unit due to clinical suspicion of malabsorption. Serum anti‐tissue transglutaminase (tTG) antibodies IgA and IgG, as well as total IgA levels, were also investigated. Furthermore, EMAs IgA and IgG1 were evaluated in biopsy culture supernatants. Biopsy specimens were also admitted to histological and immunohistochemical evaluation. Twenty‐six patients with gastroenterological disease other than coeliac disease (CD) were used as a disease control group. Ninety‐nine blood donors were used as a healthy control group.Results. Diagnosis of CD was based on histological findings in the 110/1399 patients showing EMA IgA positivity, and in a further 56/1399 patients presenting both EMA IgA and IgG1 positivity in sera as well as in culture supernatants. Of the remaining 1233 EMA IgA‐negative patients, 60 showed only EMA IgG1 positivity both in sera and in culture supernatants. It is noteworthy that anti‐tissue transglutaminase antibodies IgG (anti‐tTG) were positive in all 60 EMA IgG1‐positive patients as well. By contrast, a selective IgA deficiency was found in only 11 out of the 60 EMA IgG1‐positive patients. Villous height/crypt depth ratio was < 3:1 in 38 of the 60 EMA IgG1‐positive patients (63.3%), whilst overexpression of ICAM‐1 and CD25 was observed in all these patients.Conclusions. In this study, we observed a group of CD patients who were EMA IgG1‐positive even in the absence of EMA IgA positivity and IgA deficiency. The diagnosis was based on the finding of the gluten‐dependent clinical and histological features typical of CD. Data emerging from the present investigation thus suggest that the prevalence of CD should be reassessed and that the determination of EMA IgG1 could offer a new tool in the diagnostic armamentarium of CD.
Comparison of echocardiography and radionuclide ventriculography in the follow‐up of left ventricular systolic function in adult lymphoma patients during doxorubicin therapy
Authors: Nousiainen T. , Vanninen E. , Jantunen E. , Puustinen J. , Remes J. , Rantala A. , Hartikainen J. 
Published: March 2003

Abstract. Nousiainen T, Vanninen E, Jantunen E, Puustinen J, Remes J, Rantala A, Hartikainen J (Kuopio University Hospital; Satakunta Central Hospital, Pori; Finland). Comparison of echocardiography and radionuclide ventriculography in the follow‐up of left ventricular systolic function in adult lymphoma patients during doxorubicin therapy (Original Article). J Intern Med 2001; 249: 297–303. Objectives. To compare echocardiography (ECHO) and radionuclide ventriculography (RVG) in the monitoring of left ventricular systolic function during doxorubicin therapy in adult lymphoma patients. Design. Prospective study. Settings. University hospital. Subjects. A total of 28 adult patients who received doxorubicin to a cumulative dose of 400–500 mg m–2. Main outcome measures. ECHO and RVG were performed at baseline and after cumulative doxorubicin doses of 200, 400 and 500 mg m–2. Results. At baseline, the mean (±SE) left ventricular ejection fractions (LVEF) were 58 ± 1.3, 71 ± 1.8 and 58 ± 1.7% as determined by RVG, M‐mode ECHO and two‐dimensional (2D) ECHO, respectively. After the cumulative doxorubicin dose of 500 mg m–2 LVEF decreased to 49.6 ± 1.7% (RVG) (P < 0.001), 62 ± 1.6% (M‐mode) (P=0.006) and 52.5 ± 1.3% (2D ECHO) (P=0.036). Although a significant correlation between LVEF determined by RVG and M‐mode ECHO (r=0.615, P=0.002) and a trend between RVG and 2D ECHO (r=0.364, P=0.096) were observed, there were substantial differences in the results of individual patients. In the agreement analysis using the method of Bland and Altman there was a mean difference of 12% units with the upper limit of agreement +26% units and the lower limit of agreement –2.1% units for LVEF determinations with M‐mode ECHO and RVG, and a mean difference of 3.3% units with upper and lower limits of agreement +19.6 and –13.1% units for LVEF determinations with 2D ECHO and RVG, respectively. Conclusion. We found only a moderate agreement between left ventricular systolic function determined by ECHO and RVG methods. Thus, in the follow‐up of left ventricular function in adult patients during doxorubicin therapy, the guidelines based on LVEF measurement by RVG cannot be applied to ECHO. Consequently, RVG remains the method of choice in this context.
A high prevalence of hypovitaminosis D in Finnish medical in‐ and outpatients
Authors: Kauppinen‐Mäkelin R. , Tähtelä R. , Löyttyniemi E. , Kärkkäinen J. , Välimäki M. J. 
Published: March 2003

Abstract. Kauppinen‐Mäkelin R, Tähtelä R, Löyttyniemi E, Kärkkäinen J, Välimäki MJ (Peijas Hospital, Vantaa; United Laboratories, Leiras Research, and Division of Endocrinology; Helsinki University Central Hospital, Helsinki, Finland). A high prevalence of hypovitaminosis D in Finnish medical in‐ and outpatients. J Intern Med 2001; 249: 559–563. Objective. To study the prevalence of hypovitaminosis D [serum 25(OH)D ≤ 37 nmol L−1)] in Finnish medical in‐ and outpatients in a cross‐sectional study. Methods. The subjects were 106 consecutive medical inpatients (57 females, 49 males with mean ages of 65 and 58 years) from the Peijas Hospital, Vantaa, Finland, and 99 ambulatory patients (48 females, 51 males with mean ages of 42 and 46 years) contacting a private outpatient centre in Helsinki, Finland. Serum 25(OH)D, vitamin D binding protein (DBP), free vitamin D index (FDI), intact PTH (iPTH), and albumin‐corrected calcium were measured. Results. Serum 25‐hydroxyvitamin D [25(OH)D] was 37 nmol L−1 or less in 70% of female and in 61% of male inpatients and in 44% of female and in 37% of male outpatients. In the whole population, a statistically significant inverse association (P < 0.0001) was detected between iPTH and 25(OH)D levels; the iPTH concentration appeared to start increasing when 25(OH)D concentration was 50 nmol L−1 or less. The association remained the same (P < 0.0001) when FDI was used instead of 25(OH)D in the calculations. When the sexes were analysed separately, the statistically significant association was found only in females (P < 0.0001 for iPTH versus 25(OH)D; P < 0.0001 for iPTH versus FDI) but not in males. Conclusion. Hypovitaminosis D is very common amongst Finnish in‐ and outpatients in both sexes, causing secondary hyperparathyroidism in females. More extensive studies are warranted to elucidate the vitamin D status of the Finnish population.
Use of dietary supplements and natural remedies increased dramatically during the 1990s
Authors: Messerer M. , Johansson S.‐E. , Wolk A. 
Published: March 2003

Abstract. Messerer M, Johansson S‐E, Wolk A (Karolinska Institutet and Statistics Sweden, Stockholm, Sweden). Use of dietary supplements and natural remedies increased dramatically during the 1990s. J Intern Med 2001; 250: 160–166. Objectives. To estimate the prevalence and trends in dietary supplement and natural remedy use in Sweden during the 1980s and 1990s. Design. Three nationally representative, cross‐sectional surveys conducted in 1980–81, 1988–89 and 1996–97 were used for analysis. In face‐to‐face interviews participants reported consumption of dietary supplements and natural remedies during the previous 2 weeks. Setting. Sweden. Subjects. The samples consisted totally of 38 594 adults aged 16–84 years (14 642 in the 1980–81 survey, 12 391 in the 1988–89 survey and 11 561 in the 1996–97 survey). Main outcome measures. Changes in prevalence of dietary supplement and natural remedy users between 1980 and 1997. Results. The 70% increase in the prevalence of dietary supplement users amongst both men and women [odds ratio (OR), 1.7; 95% confidence interval (CI), 1.6–1.9, OR, 1.7; 95% CI, 1.5–1.8, respectively] occurred mainly between 1988–89 and 1996–97. The increase in the prevalence of natural remedy users was even more dramatic – more than threefold in men (OR, 3.3; 95% CI, 2.9–4.0) and almost threefold in women (OR, 2.6; 95% CI, 2.3–2.9) – and the systematic increase started already in the 1980s. The increase was observed in all age groups and in all socio‐economic groups, except for farmers. In 1996–97 the prevalence of dietary supplement users was 22% amongst men and 33% amongst women, and of natural remedies 7 and 14%, respectively. Conclusions. During the last two decades, the use of dietary supplements and natural remedies amongst the adult Swedish population has dramatically increased.
Screening for thyroid disease of 15–17‐year‐old schoolchildren in an area with normal iodine intake
Authors: Milakovic M. , Berg G. , Eggertsen R. , Lindstedt G. , Nyström E. 
Published: March 2003

Abstract. Milakovic M, Berg G, Eggersten R, Lindstedt G, Nyström E (Sahlgrenska University Hospital, Göteborg, Sweden). Screening for thyroid disease of 15–17‐year‐old schoolchildren in an area with normal iodine intake. J Intern Med 2001; 250: 208–212. Objective. The prevalence of thyroid disease in Swedish schoolchildren is today insufficiently known. The aim of the study was therefore to determine the prevalence of abnormal thyroid function and thyroid autoimmunity in teen‐age schoolchildren and to compare the findings with a healthy control group of 60–65‐year‐old inhabitants from the same community. Setting. A semirural community of approximately 15 000 inhabitants. Design. Cross‐sectional study. Main outcome measures. Thyroid volume and serum concentrations of serum thyrotropin (TSH), total and free thyroxine (T4), total and free 3,5,3′‐triiodothyronine (T3), and antithyroperoxidase antibodies (TPOAb). Results. Four schoolchildren (7%, 59 screened) had elevated TPOAb concentration, three of the subjects being girls (8%). One girl with a goitre was overtly hypothyroid and one girl showed borderline‐high serum TSH concentration suggesting subclinical autoimmune thyroid disease. One euthyroid boy had a goitre and high concentration of TPOAb. The serum free T3 concentration was significantly higher in 15–17‐year‐old than 60–65‐year‐old (7.4 vs. 6.4 pmol L–1, P < 0.001). The concentrations of other thyroid hormones and of TSH in 15–17‐year‐old did not differ from those of the 60–65‐year‐old. Conclusions. We found three cases of thyroid disease in need of immediate attention or later follow‐up. The prevalence of autoimmune thyroid disease was high as indicated from TPOAb measurements. Thyroid tests including TPOAb measurement should be performed on wide indications when teenagers seek medical advice. The reference intervals for teen‐age children for commonly used first line tests (TSH and free T4) do not differ from those for adults.
Value of structured clinical and scintigraphic protocols in acute pulmonary embolism
Authors: Nilsson T. , Måre K. , Carlsson A. 
Published: March 2003

Abstract. Nilsson T, Måre K, Carlsson A (Karolinska Hospital, Linköping University Hospital; and Danderyd Hospital, Sweden). Value of structured clinical and scintigraphic protocols in acute pulmonary embolism. J Intern Med 2001; 250: 213–218. Purpose. To study the use of a combination of a clinical and scintigraphic protocol in relation to the final outcome diagnosis in patients with clinical suspicion of acute pulmonary embolism (PE). Material and methods. A total of 170 patients with clinical suspicion of acute PE were all examined with ECG, blood chemistry, chest X‐ray, pulmonary scintigraphy and selective pulmonary arteriography. The scintigraphic and clinical probabilities of PE were estimated on visual analogue scales (VASs) by different readers unaware of each others’ results. The follow‐up time was 6 months. In order to establish the final diagnosis a final outcome committee was created. They analysed in retrospect all the clinical and laboratory data and established whether the patient had had PE or not. Results. The final outcome committee concluded that 53 patients had PE. When the scintigraphic and clinical probability judgements were congruent, a combined probability of 1–25% (i.e low probability) had a negative predictive value of 98%. When the combined probability was 26–75% (i.e. intermediate) half of the cases had PE. With a combined probability of 76–100% (i.e. high) the positive predictive value was 100%. Conclusion. By applying a model of combined clinical and scintigraphic probabilities for PE, the diagnosis is ruled in when the combined probability is high, and ruled out when the combined probability is low. However, nearly half of the patients will still have an uncertain diagnosis for which further diagnostic procedures may be allocated.
A definition‐based analysis of symptoms in a large cohort of patients with chronic fatigue syndrome
Authors: De Becker P. , McGregor N. , De Meirleir K. 
Published: March 2003

Abstract. De Becker P, MCGregor N, De Meirleir K (VUB, Vakgroep Interne Geneeskunde, Brussels, Belgium; and University of Newcastle, Callaghan, New South Wales, Australia). A definition‐based analysis of symptoms in a large cohort of patients with chronic fatigue syndrome. J Intern Med 2001; 250: 234–240. Objective. The Holmes and Fukuda criteria are widely used criteria all over the world, yet a specific European study regarding chronic fatigue syndrome (CFS) patient symptomatology has not been conducted so far. This study was performed to answer the need to assess the homogeneity of a large CFS population in relationship to the Fukuda or Holmes definitions and to assess the importance of a symptom severity scale. Design. Multivariate analyses were performed to assess the symptom presentation within a fatigued population and the differences between the Fukuda and Holmes definitions compared with an excluded chronic fatigued group in a large cohort of fatigued patients. Setting. An outpatient tertiary care setting fatigue clinic in Brussels. Main outcome measures. Prevalence and severity of symptoms and signs in a CFS population and in a chronic fatigued population. Subjects and methods. A total of 2073 consecutive patients with major complaints of prolonged fatigue participated in this study. Multivariate analyses were performed to assess the symptom presentation and severity and the differences between the Fukuda and Holmes definitions. Results. Of the 2073 patients complaining of chronic fatigue (CF), 1578 CFS patients fulfilled the Fukuda criteria (100% of CFS group) and 951 (60.3% of the CFS group) fulfilled the Holmes criteria. Discriminant function analysis revealed that the Fukuda and Holmes definitions can be differentiated by symptom severity and prevalence. The Holmes definition was more strongly associated than the Fukuda definition with the symptoms that differentiated the CFS patients from the patients that did not comply with the CFS definitions. The inclusion of 10 additional symptoms was found to improve the sensitivity/specificity and accuracy for selection of CFS patients. Conclusions. The CFS patients fulfilling the Holmes criteria have an increased symptom prevalence and severity of many symptoms. Patients fulfilling the Fukuda criteria were less severely affected patients which leads to an increase in clinical heterogeneity. Addition of certain symptoms and removal of others would strengthen the ability to select CFS patients.