bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognosis of persons with type 1 diabetes on intensified insulin therapy in relation to nephropathy
Authors: Mühlhauser I. , Sawicki P. T. , Blank M. , Overmann H. , Bender R. , Berger M. 
Published: March 2003

Abstract. Mühlhauser I, Sawicki PT, Blank M, Overmann H, Bender R, Berger M (University of Düsseldorf, Düsseldorf; University of Hamburg, Hamburg; and University of Bielefeld, Bielefeld, Germany). Prognosis of persons with type 1 diabetes on intensified insulin therapy in relation to nephropathy. J Intern Med 2000; 248: 333–341.Objective. To study the prognosis of persons with type 1 diabetes in relation to the degree of nephropathy at initiation of intensified insulin therapy.Design. Ten years follow‐up of a cohort of 3674 patients who had participated in a 5‐day group treatment and teaching programme for intensification of insulin therapy between September 1978 and December 1994.Setting. Ten diabetes centres in Germany.Subjects. A total of 3674 patients (insulin treatment before age 31), age at baseline 27 ± 10 years, with a diabetes duration of 11 ± 9 years. Patients were divided into three groups according to baseline renal parameters (group I, normal proteinuria, n = 1829; group II, microproteinuria, n = 1257; group III, at least macroproteinuria, n = 367).Main outcome measures. End‐stage diabetic complications (blindness, amputations, renal replacement therapy), standardized mortality ratios (SMR) and causes of death.Results. Outcome measures were documented for 97% of patients; 251 (7%) had died. During follow‐up, 1% of patients in group I, 4% in group II, and 47% in group III had at least one end‐stage diabetic complication. SMR for men: nephropathy group I, 2.2 (95% CI = 1.5–3); group II, 3.2 (2.3–4.3); group III, 11.5 (8.8–14.7). SMR for women: group I, 2.5 (1.5–3.8); group II, 3.5 (2.2–5.3), group III, 27 (19.8–35.9). Causes of death for men and women combined: group I (total 58 deaths) – cardiovascular, 21 (36%); hypoglycaemia, 1; ketoacidosis, 3; violent deaths, 17 (29%); others, 16; group II (66 deaths) – cardiovascular, 25 (38%); hypoglycaemia, 2; ketoacidosis, 2; violent deaths, 14 (21%); others, 23; group III (114 deaths) – cardiovascular, 68 (60%); hypoglycaemia, 2; ketoacidosis, 5; infections, 15 (13%); violent deaths, 5 (4%); others, 19.Conclusions. Patients with microproteinuria have only a slightly worse prognosis than patients with normal proteinuria during the first 10 years after initiation of intensified insulin therapy. Excess mortality amongst patients who started intensified insulin therapy is mainly due to those with manifest clinical nephropathy.
Consulting the source code: prospects for gene‐based medical diagnostics
Authors: Landegren U. 
Published: March 2003

Abstract. Landegren U (Rudbeck Laboratory, Uppsala, Sweden) Gene‐based diagnostics (Internal Medicine in the 21st Century). J Intern Med 2000; 248: 271–276.Gene‐based diagnostics has been slow to enter medical routine practice in a grand way, but it is now spurred on by three important developments: the total genetic informational content of humans and most of our pathogens is rapidly becoming available; a very large number of genetic factors of diagnostic value in disease are being identified; and such factors include the identity of genes frequently targeted by mutations in specific diseases, common DNA sequence variants associated with disease or responses to therapy, and copy number alterations at the level of DNA or RNA that are characteristic of specific diseases. Finally, improved methodology for genetic analysis now brings all of these genetic factors within reach in clinical practice.The increasing opportunities for genetic diagnostics may gradually influence views on health and normality, and on the genetic plasticity of human beings, provoking discussions about some of the central attributes of genetics.
Gene transfer and the treatment of haematological malignancy
Authors: Brenner M.K. 
Published: March 2003

Abstract. Brenner MK. Gene transfer and the treatment of haematological malignancy (Minisymposium). J. Intern Med 2001; 249: 345–358.Gene therapy offers an additional therapeutic modality for treating haematological malignancy. Because gene therapies could be truly specific for the malignancy, they should ultimately prove both safe and effective. We have far to go before this full potential is realized, but gene transfer strategies are already showing therapeutic promise. Gene transfer may be used to correct the genetic defect in the tumour, to render it more susceptible to conventional therapies, or the normal host cells more resistant, to induce or amplify an antitumour immune response, or simply as a means of tracking the tumour or cells used for treatment. This article describes examples of each approach and discusses future prospects for the field.
The relationship between educational level and mortality. The Reykjavík Study
Authors: Hardarson T. , Gardarsdóttir M. , Gudmundsson K. TH. , Thorgeirsson G. , Sigvaldason H. , Sigfússon N. 
Published: March 2003

Abstract. Hardarson T, Gardarsdóttir M, Gudmundsson KTh, Thorgeirsson G, Sigvaldason H, Sigfússon N (National University Hospital, Reykjavík and University of Iceland; and Icelandic Heart Association, Reykjavík, Iceland). The relationship between educational level and mortality. The Reykjavík Study. J Intern Med 2001; 249: 495–502. Objectives. Epidemiological studies have indicated an association between socioeconomic factors and health. It has not been clearly established whether this association is wholly or partly independent of classical risk factors. Our objective was to estimate the relationship between educational level and coronary artery disease (CAD), mortality and all‐cause mortality. The Reykjavík Study involving 18 912 participants followed‐up 4–30 years provides an ideal opportunity to address this question. Design and subjects. The participants were aged 33–81 years and living in the Reykjavík area. They were divided into four groups according to education. The standard risk factors were assessed on entry and mortality, and cause of death registered during follow‐up. Multiple Cox regression analysis was applied to assess the relationship between age at examination, year of examination, educational level and mortality. Results. The all‐cause mortality and CAD mortality was significantly related to education, even after adjustment for classical risk factors. For men, 14% (95% CI: 2–24) reduction was found in CAD mortality for those having high school education relative to elementary school. The figures for junior college and university education were 17% (95% CI: 1–31) and 38% (95% CI: 21–32), respectively. These figures were only slightly lower when major CAD risk factors were controlled for and still significant. Similar figures were found for all‐cause mortality. For women 34% (95% CI: 18–48) reduction was found in CAD mortality for high school education and 55% (95% CI: 22–74) for junior college, but too few had university education for reliable results. The figures were lower for all‐cause mortality, but significant. The figures were reduced when major CAD risk factors were controlled for, but still significant. Conclusion. Education is a strong protective factor both for all‐cause and CAD mortality. Only a small part of this effect can be explained through conventional risk factors.
Rosiglitazone treatment of patients with extreme insulin resistance and diabetes mellitus due to insulin receptor mutations has no effects on glucose and lipid metabolism
Authors: Vestergaard H. , Lund S. , Pedersen O. 
Published: March 2003

Abstract. Vestergaard H, Lund S, Pedersen O (Herlev Hospital, University of Copenhagen, Herlev; and Steno Diabetes Center, Gentofte; Denmark). Rosiglitazone treatment of patients with extreme insulin resistance and diabetes mellitus due to insulin receptor mutations has no effects on glucose and lipid metabolism. J Intern Med 2001; 250: 406–414. Background. Rosiglitazone, a thiazolidinedione (TZD), increases insulin sensitivity by reducing levels of plasma NEFA, triglycerides (TG), glucose and serum insulin. Rosiglitazone treatment decreases insulin resistance in type 2 diabetic patients, but no data exist concerning rosiglitazone treatment of patients with syndromes of extreme insulin resistance. Objectives. To evaluate whether hyperglycaemia in two lean patients with primary severe insulin resistance due to insulin receptor (IR) mutations and diabetes mellitus could be reduced by supplement of rosiglitazone for 180 days and secondary, to evaluate the effects on plasma NEFA, TG, Apo B, PAI‐1 and serum insulin. Subjects. Both patients (brothers) have known mutations in the IR gene localized to the tyrosine kinase domain and a deletion of exon 17 in part of their IR mRNA. Prior to the study the HbA1C values were higher than 10% in both patients for more than 12 months during treatment with insulin and metformin. Results. After 180 days of rosiglitazone supplement (8 mg day−1), no changes were observed in fasting plasma glucose and HbA1C. Incremental plasma glucose areas under the curves during a 75‐g oral glucose tolerance test (OGTT) were unchanged. Likewise, no improvements were seen in either first or second phase insulin secretion during a 0.3 g kg−1 intravenous glucose tolerance test (IVGTT). Fasting plasma VLDL and HDL cholesterol, TG and Apo B levels were unchanged, whereas a small increase was seen in total and LDL cholesterol levels. Fasting plasma NEFA increased by 51% in KC after 90 days of treatment, and after 180 days plasma NEFA was still 26% higher, when compared with pretreatment levels. In BC an initial 16% decrease was seen in plasma NEFA after 90 days of treatment. Plasma NEFA was increased 14% after 180 days of treatment, when compared with pretreatment levels, but 35% when compared with day 90. Plasma PAI‐1 decreased in both patients after 45 and 90 days of treatment but the decrease was only maintained in KC (47%). Conclusions. Rosiglitazone treatment, in combination with insulin and metformin, of patients with severe primary insulin resistance due to IR mutations and diabetes mellitus, had no impact on the measured estimates of glucose and lipid metabolism. These findings may suggest that the effect of rosiglitazone on glucose and lipid metabolism are dependent on the presence of intact IR protein.
Serum free fatty acid pattern and risk of myocardial infarction: a case‐control study
Authors: YLI‐JAMA P. , MEYER H. E. , RINGSTAD J. , PEDERSEN J. I. 
Published: March 2003

Abstract. Yli‐Jama P, Meyer HE, Ringstad J, Pedersen JI (Medical Faculty, University of Oslo; National Health Screening Services, Oslo; and Østfold Central Hospital, Norway). Serum free fatty acid pattern and risk of myocardial infarction: a case‐control study. J Intern Med 2002; 251: 19–28. Objectives. To investigate the association between composition of serum free fatty acid (FFA) fraction and risk of a first myocardial infarction (MI). Design. A case‐control design. Setting. The patients were recruited from Ullevål Hospital in Oslo and Østfold Central Hospital in Fredrikstad and Sarpsborg, Norway. Subjects. A total of 103 patients with first MI and 104 population controls, both men and postmenopausal women, age 45–75  years. Results. The mean molar percentage content of docosahexaenoic (DHA), eicosapentaenoic (EPA), stearic and myristic acid in the serum FFA fraction was significantly lower in cases than in controls, whereas that of oleic and linoleic acid was higher in cases. Increased percentage content of total very long‐chain omega‐3 fatty acids (VLC n‐3) in serum FFA was associated with decreased risk of MI. Multivariate odds ratio (OR), adjusted for age, sex, waist‐hip ratio, smoking, family history of coronary heart disease (CHD) and years of education was 0.20 (95% CI 0.06–0.63) for the highest vs. lowest quartile. Also increased content of stearic acid was associated with decreased risk. Multivariate OR adjusted as above was 0.38 (95% CI 0.14–1.04) for the highest versus lowest quartile. After adjustment for oleic acid, however, the inverse linear trend was no longer significant. Conclusions. The percentage content of VLC n‐3 as well as of stearic acid in serum FFA was inversely associated with risk of myocardial infarction. That of VLC n‐3 may reflect diet, but additionally these free fatty acids might in some way be related to the pathogenetic process and not only reflect their content in adipose tissue.
Costs for screening, intervention and hospital treatment generated by the Malmö Preventive Project: a large‐scale community screening programme
Authors: NORINDER A. , PERSSON U. , NILSSON P. , NILSSON J.‐Å. , HEDBLAD B. , BERGLUND G. 
Published: March 2003

Abstract. Norinder A, Persson U, Nilsson P, Nilsson J‐Å, Hedblad B, Berglund G (Swedish Institute for Health Economics, Lund; and University Hospital, Malmö, Sweden). Costs for screening, intervention and hospital treatment generated by the Malmö Preventive Project: a large‐scale community screening programme. J Intern Med 2002; 251: 44–52. Objectives. The purpose of this study was to estimate retrospectively the costs of health care resources used in the Malmö Preventive Project, Sweden and estimate the costs of in‐patient care that were avoided because of early intervention. Setting and subjects. A large‐scale community intervention programme was conducted from 1974 to 1992 in Malmö, Sweden with the aim of reducing morbidity and mortality of cardiovascular diseases (CVD), alcohol related illnesses, and breast cancer. Between 1974 and 1992, 33 336 male and female subjects were screened for hypertension, hyperlipidaemia, type‐2 diabetes and alcohol abuse. Intervention programmes that included life‐style modifications, follow‐up visits with physicians and nurses and drug therapy were offered to about 25% of screened subjects. Methods. Recruitment costs were generated through out the screening period. Intervention costs were estimated for 5 years after screening. Excess in‐patient care costs were estimated by subtracting hospital consumption for an unscreened, matched cohort from that of the screened cohort over follow‐up periods of 13–19 years. Intervention and excess in‐patient care costs were estimated until 1996. Results. The net expenditures for recruitment and intervention was SEK253 million and saved costs for in‐patient care of SEK143 millions (1998 prices). Considering the opportunity cost of the resources used in the study, the net cost rises to about SEK200 millions. Conclusion. The results suggest that only part of the intervention costs were offset by reduction in future morbidity health care costs. This is in line with results from prospective analyses of other primary prevention programmes.
Interleukin‐1 receptor antagonist is detectable in human carotid artery plaques and is related to triglyceride levels and Chlamydia pneumoniae IgA antibodies
Authors: GOTTSÄTER A. , FORSBLAD J. , MÄTZSCH T. , PERSSON K. , LJUNGCRANTZ I. , OHLSSON K. , LINDGÄRDE F. 
Published: March 2003

Abstract. Gottsäter A, Forsblad J, Mätzsch T, Persson K, Ljungcrantz I, Ohlsson K, Lindgärde F (Malmö University Hospital, University of Lund, Malmö, Sweden). Interleukin‐1 receptor antagonist is detectable in human carotid artery plaques and is related to triglyceride levels and Chlamydia pneumoniae IgA‐antibodies. J Intern Med 2002; 251: 61–68. Objectives. To investigate whether the interleukin‐1 receptor antagonist (Il‐1ra) and interleukin‐1β (Il‐1β) can be detected in human carotid artery tissue, and whether their presence is related to evidence of Chlamydia pneumoniae infection, risk factors for atherosclerosis, and clinical data. Setting. Departments of Vascular Diseases and Surgical Pathophysiology, University Hospital, Malmö, Sweden. Subjects. A total of 66 patients undergoing carotid endarterectomy (median age 74, range 53–89 years, 26 women). Il‐1β and Il‐1ra were studied in carotid artery plaques and in Il‐1ra in serum. Results. Interleukin‐1 receptor antagonist was detected in mononuclear cells in plaques from 37/66 (56%) patients. Patients with Il‐1ra in plaques showed higher [2.04 (1.70–3.14) mmol L–1 vs. 1.69 (1.09–1.99) mmol L–1; P < 0.05] serum(s‐)triglyceride(tg) levels, and a higher frequency of IgA seropositivity for C. pneumoniae (76% vs. 52%; P < 0.05) than those without. S‐Il‐1ra levels correlated with s‐tg levels (r=0.38; P=0.047). There were no differences between patients with and without Il‐1ra in plaques concerning s‐Il‐1ra, blood(b‐)haemoglobin or leucocyte count, s‐cholesterol, b‐glucose, blood pressure, IgG seropositivity for C. pneumoniae, prevalence of neurological symptoms preceding operation, smoking, or diabetes mellitus. There were no differences in frequency of Il‐1ra in plaques or in s‐Il‐1ra levels between patients with symptomatic and asymptomatic stenosis, between smokers and nonsmokers, or between diabetic and nondiabetic patients. Il‐1β was not detected in plaques in the current study. Conclusion. Interleukin‐1 receptor antagonist can be detected in human atherosclerotic carotid artery plaques, and is related to s‐triglyceride levels and IgA seropositivity for C. pneumoniae, but not to prevalence of neurological symptoms related to embolization.
Endothelial nitric oxide synthase gene Glu298Asp polymorphism and blood pressure, left ventricular mass and carotid artery atherosclerosis in a population‐based cohort
Authors: Karvonen J. , Kauma H. , Kervinen K. , Rantala M. , Ikäheimo M. , Päivänsalo M. , Savolainen M. J. , Kesäniemi Y. A. 
Published: March 2003

Abstract. Karvonen J, Kauma H, Kervinen K, Rantala M, Ikäheimo M, Päivänsalo M, Savolainen MJ, Kesäniemi YA (University of Oulu, Oulu; Finland). Endothelial nitric oxide synthase gene Glu298Asp polymorphism and blood pressure, left ventricular mass and carotid artery atherosclerosis in a population‐based cohort. J Intern Med 2002; 251: 102–110. Objective. Decreased production of endothelial nitric oxide (NO) is associated with different cardiovascular pathology. We studied the association between the Glu298Asp polymorphism of the NO producing gene, endothelial nitric oxide synthase (eNOS), and hypertension, left ventricular mass (LVM) and carotid artery intima‐media thickness (IMT) in a population‐based cohort of hypertensive and control subjects. Design. Cross‐sectional case–control study. Setting. District around Oulu University Hospital, Northern Finland. Subjects and methods. The study population consisted of 600 middle‐aged hypertensive subjects (300 men and 300 women) and 600 controls (300 men and 300 women) living in the City of Oulu. The hypertensive subjects were randomly selected by age stratification from the Social Insurance Institute register for reimbursement of antihypertensive medication. For each hypertensive subject, an age‐ and sex‐matched control was randomly selected from the national health register. The overall participation rate was 87.8%. In the present study a total of 1024 subjects were screened. Echocardiographic examinations were performed by a trained cardiologist and carotid ultrasonographic examinations by a trained radiologist. Results. The genotype distributions and allele frequencies between the hypertensive and control subjects and the relationship between the Glu298Asp variant and blood pressure, LVM and carotid artery IMT were determined. No differences in genotype distribution or allele frequencies were found between the hypertensive and control groups (the frequency of the Asp allele 0.299 vs. 0.288, respectively). Also, we could not find any association between the eNOS genotype and the measured cardiovascular complications. Conclusions. The Glu298Asp variant of the eNOS gene does not seem to be a major risk factor for cardiovascular alterations in the general population.
Preventing atherothrombotic events in peripheral arterial disease: the use of antiplatelet therapy
Authors: Hiatt W. R. 
Published: March 2003

Abstract.  Hiatt WR (University of Colorado Health Sciences Center and the Colorado Prevention Center, Denver, CO, USA). Preventing atherothrombotic events in peripheral arterial disease: the use of antiplatelet therapy (Review). J Intern Med 2002; 251: 193–206.Patients with peripheral arterial disease (PAD) are at increased risk of generalized atherothrombotic events. Epidemiologic data shows a high rate of co‐prevalence of PAD and atherosclerosis in other vascular beds. Aggressive risk‐factor modification and antiplatelet therapy has become the cornerstone of treatment to prevent ischaemic events associated with PAD. Recent clinical trials have confirmed the clinical benefit of clopidogrel and ticlopidine in patients with PAD, agents that irreversibly inhibit the binding of adenosine diphosphate to its platelet receptor. In the clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE) trial, clopidogrel was associated with an overall risk reduction of 8.7% (compared with aspirin, P=0.043) in myocardial infarction (MI), ischaemic stroke and vascular death. These results demonstrated that long‐term administration of clopidogrel was effective in preventing ischaemic events in patients with atherosclerotic vascular disease including PAD. Aspirin and/or clopidogrel are the antiplatelet agents of choice for the reduction of atherothrombotic events in patients with PAD.
Treatment of sarcoidosis – from a basic science point of view
Authors: Moller D. R. 
Published: March 2003

Abstract. Moller DR (John Hopkins University School of Medicine, Baltimore, MD, USA). Treatment of sarcoidosis – from a basic science point of view (Minisymposium).J Intern Med2003;253:31–40.Progress in our understanding of the scientific basis of granulomatous inflammation in sarcoidosis provides a framework for enlightened treatment decisions. Current evidence supports the concept that the pathogenesis of sarcoidosis involves a highly polarized T‐helper 1 (Th1) immune response to pathogenic tissue antigens. Conventional treatment is focused on attenuating granuloma formation with antimalarial drugs that inhibit antigen presentation or with nonspecific anti‐inflammatory agents such as glucocorticosteroids, methotrexate, or azathioprine. Anti‐tumour necrosis factor (TNF)‐α agents such as pentoxifylline, thalidomide, etanercept and remicade, have recently shown some successes in sarcoidosis. Designing future therapies depends on improved knowledge of the critical immunological processes operative in different stages of disease.
Source point calibration from an arbitrary electron backscattering pattern
Authors: KRIEGER LASSEN N. C. 
Published: March 2003

Precise knowledge of the position of the source point is a requirement if electron backscattering patterns (EBSPs) are to be used for crystal orientation measurements or other types of measurements which demand a geometrical analysis of the patterns. Today, possibly the most popular method for locating the source point is a computational technique which uses the positions of a number of indexed Kikuchi bands for calculating the coordinates of the point. A serious limitation of this calibration technique is, however, that the localized bands must first be indexed, which is difficult if the location of the source point is not known with reasonable precision.This paper describes a new technique which determines the location of the source point from the positions of a number of bands in an arbitrary EBSP. Besides the positions of the Kikuchi bands, the only information which is required by this new calibration procedure is the same crystallographic information which is used for normal indexing of EBSPs. The procedure is shown to work successfully with patterns from a simple cubic crystal, as well as with patterns from an orthorhombic BiSCCO superconductor. In the former case, four bands are shown to be sufficient to ensure a unique determination of the source point, whereas five bands are required in the latter case. Once the bands have been localized, the time required for calculating the source point position is of the order of 1 min on a standard PC.