bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in long‐term survival after myocardial infarction: less favourable patterns for patients from deprived areas
Authors: Engström G. , Göransson M. , Hansen O. , Hedblad B. , Tydén P. , Tödt T. , Janzon L. 
Published: March 2003

Abstract. Engström G, Göransson M, Hansen O, Hedblad B, Tydén P, Tödt T, Janzon L (Malmö University Hospital, Malmö, Sweden). Trends in long‐term survival after myocardial infarction: less favourable patterns for patients from deprived areas. J Intern Med 2000; 248: 425–434.Objective. New treatments have improved the prognosis for patients with acute myocardial infarction. However, studies on long‐term survival are not unequivocally in favour of an improved long‐term prognosis. This study aimed to analyse trends in 3‐year survival in relation to sex, age and socioeconomic level of residential area.Setting. The Malmö myocardial infarction register, Sweden.Participants. All men and women in the city who, between 1978 and 1995, were admitted for a first acute myocardial infarction (n = 11 226).Main outcome measures. Age‐standardized 3‐year survival rates.Results. Both 28‐day and 3‐year survival rates improved markedly during the study period. Age‐standardized 3‐year survival (per 100 patients) amongst men and women who survived 28 days increased, between 1978–81 and 1991–95, from 64 to 78 in men and from 66 to 77 in women, an annual increase of 1.4% (95% CI = 1.1–1.7) and 1.2% (0.8–1.5), respectively. There were marked differences in survival between residential areas with different socioeconomic circumstances. The 3‐year survival rates amongst men correlated significantly with the socioeconomic circumstances in the areas expressed in terms of a socioeconomic score (men: r = 0.60, n = 17, P = 0.01; women: r = 0.37, P = 0.15). Trends tended to be less favourable in deprived areas.Conclusion. Three‐year survival after first myocardial infarction has continuously improved for men and women in all age groups. Prognosis was worse and trends tended to be less favourable for patients from deprived areas.
Lentiviral‐mediated gene transfer into haematopoietic stem cells
Authors: Woods N.‐B. , Mikkola H. , Nilsson E. , Olsson K. , Trono D. , Karlsson S. 
Published: March 2003

Abstract. Woods N‐B, Mikkola H, Nilsson E, Karin O, Trono D, Karlsson S (Lund University Hospital, Sweden; and University of Geneva Medical School, Switzerland). Lentiviral‐mediated gene transfer into haematopoietic stem cells (Minisymposium). J Intern Med 2001; 249: 339–343. Objectives. Lentiviral vectors can transduce nondividing cells. As most haematopoietic stem cells (HSCs) are nondividing in vivo, lentiviral vectors are promising viral vectors to transfer genes into HSCs. Design and Setting. We have used HIV‐1 based lentiviral vectors containing the green fluorecent protein (GFP) gene to transduce umbilical cord blood CD34+ and CD34+/CD38– cells prior to transplantation into NOD/SCID mice. Results. High level engraftment of human cells was obtained and transgene expression was seen in both myeloid and lymphoid lineages. Bone marrow from the primary transplant recipients mice was transplanted into secondary recipients. GFP expression was seen in both lymphoid and myeloid cells in the secondary recipients 6 weeks posttransplantation. Human haematopoietic progenitor colonies were grown from both primary and secondary recipients. Over 50% of the haematopoietic colonies in these recipients were positive for the GFP transgene by PCR. Following inverse PCR, amplified fragments were sequenced and integration of the vector into human genomic DNA was demonstrated. Several vectors containing different internal promoters were tested in NOD/SCID mice that had been transplanted with transduced CD34+ and CD34+/CD38– cells. The elongation factor‐1α (EF‐1α) promoter gave the highest level of expression, both in the myeloid and lymphoid progeny of the engrafting cells. Conclusions. These data collectively indicate that candidate human HSCs can be efficiently transduced with lentiviral vectors and that the transgene is highly expressed in their progeny cells.
Homocysteine and major coronary events: a prospective population study amongst women
Authors: Knekt P. , Alfthan G. , Aromaa A. , Heliövaara M. , Marniemi J. , Rissanen H. , Reunanen A. 
Published: March 2003

Abstract. Knekt P, Alfthan G, Aromaa A, Heliövaara M, Marniemi J, Rissanen H, Reunanen A (National Public Health Institute, Helsinki, and Social Insurance Institution, Turku, Finland). Homocysteine and major coronary events; a prospective population study amongst women. J Intern Med 2001; 249: 461–465. Objectives. To study serum homocysteine concentration for its prediction of major coronary heart disease events amongst women. Design. A case‐control study nested within a follow‐up study. Subjects. A total of 74 and 75 major coronary events (coronary deaths or nonfatal myocardial infarction) which occurred in women with and without known heart disease, respectively, during a 13‐year follow‐up and two individually matched controls per case. Main outcome measure. Major coronary event. Results. Amongst women with baseline heart disease, the relative risk (95% CI) of such events, adjusted for age, smoking, hypertension, diabetes, serum cholesterol and body mass index, was 3.32 (1.05–10.5) in the highest homocysteine quintile compared with the lowest quintile. Amongst women free of heart disease at baseline, the corresponding relative risk value was 0.77 (0.24–2.45). Conclusions. This prospective study support the hypothesis that homocysteine is a risk factor for coronary events in women with heart disease.
Microalbuminuria is common, also in a nondiabetic, nonhypertensive population, and an independent indicator of cardiovascular risk factors and cardiovascular morbidity
Authors: Hillege H. L. , Janssen W. M. T. , Bak A. A. A. , Diercks G. F. H. , Grobbee D. E. , Crijns H. J. G. M. , Van Gilst W. H. , De Zeeuw D. , De Jong P. E. ,   FOR THE PREVEND STUDY GROUP
Published: March 2003

Abstract. Hillege HL, Janssen WMT, Bak AAA, Diercks GFH, Grobbee DE, Crijns HJGM, van Gilst WH, de Zeeuw D, de Jong PE for the PREVEND Study group (University of Groningen and University Hospital Groningen, Groningen; University Medical centre, Utrecht, the Netherlands). Microalbuminuria is common, also in a nondiabetic, nonhypertensive population, and an independent indicator of cardiovascular risk factors and cardiovascular morbidity. J Intern Med 2001; 249: 519–526. Objectives. To assess the prevalence of microalbuminuria in the general population, especially in nondiabetic and nonhypertensive subjects, and its association with known cardiovascular risk factors and cardiovascular morbidity. Design. Cross‐sectional cohort study. Setting. Inhabitants of the city of Groningen, the Netherlands. Subjects. All inhabitants, aged between 28 and 75 years, were send a postal questionnaire and a vial to collect an early morning urine sample (n=85 421). Of these 40 856 subjects (47.8%) responded. Cardiovascular risk factors and morbidity were validated in a well defined nondiabetic and nonhypertensive group of 5241 subjects. Main outcome measures. Microalbuminuria, self‐reported cardiovascular risk and cardiovascular morbidity in the total study cohort, and additionally more detailed measurements in a subset of the total population. Results. Microalbuminuria (20–200 mg L–1) was present in 7.2% of the subjects and independently associated with age, gender, hypertension, diabetes, smoking, previous myocardial infarction and stroke. Some of these associations were already observed at albuminuria levels of 10–20 mg L–1. After exclusion of the diabetic and hypertensive subjects, microalbuminuria was still prevalent in 6.6% of the subjects. Conclusions. Microalbuminuria appears to be common not only in the general population but also in a nondiabetic, nonhypertensive population and is independently associated with increased cardiovascular risk factors and cardio‐vascular morbidity. Importantly, some of these associations are present at urinary albumin levels currently considered to be normal. These findings suggest that urinary albumin measurements may be useful in early risk profiling and prevention of cardiovascular disease in the population at large.
Hypercalcaemia of malignancy: an undiagnosed and undertreated disease
Authors: Lamy O. , Jenzer‐Closuit A. , Burckhardt P. 
Published: March 2003

Lamy O, Jenzer‐Closuit A, Burckhardt P (University Hospital, Lausanne, Switzerland). Hypercalcaemia of malignancy: an undiagnosed and undertreated disease. J Intern Med 2001; 250: 73–79. Background. Hypercalcaemia of malignancy, a relatively frequent phenomenon, seems to be insufficiently recognized and treated. Its symptoms are not specific, but they affect the quality of life. Methods. A prospective study to analyse the influence of symptoms caused by hypercalcaemia on the decision of the admitting physician, the motivation for treatment, and the effect of the treatment on the given symptoms in hospitalized patients with oncologic disease in progression, where confounding causes of similar symptoms such as cerebral metastasis, radiotherapy, treatment with opioids, etc., were excluded. Results. A total of 71 patients, mean age 65 + 11 years, fulfilled the strict inclusion criteria. About 42% were hospitalized because of symptoms caused by hypercalcaemia, but none of the medical reports mentioned hypercalcaemia as reason for hospitalization. Specific antihypercalcaemic therapy was given to only 37% of patients, and only 25% got an adequate rehydratation. Antihypercalcaemic treatment was guided by the severity of hypercalcaemia (>3.00 mmol L–1), not by the symptoms. Polyuria‐polydipsia, nausea‐vomiting and constipation were correlated with hypercalcaemia. These symptoms, as well as confusion‐stupor and bone pains improved significantly when calcaemia was normalized. Patients with calcaemia normalized returned home most frequently (P < 0.03). Conclusions. Malignant hypercalcaemia remains mostly undiagnosed in medical praxis. Specific treatment occurs in too small fractions of the patients. As the normalization of calcaemia significantly improves the symptoms because of hypercalcaemia and the quality of life, rapid rehydration and specific calcium lowering treatments should be part of palliative measures in all patients with malignant hypercalcaemia.
Sleep disturbance in association with elevated pulse rate for prediction of mortality – consequences of mental strain?
Authors: Nilsson P. M. , Nilsson J.‐Å. , Hedblad B. , Berglund G. 
Published: March 2003

Abstract. Nilsson PM, Nilsson J‐Å, Hedblad B, Berglund G (University Hospital, Malmö, Sweden). Sleep disturbance in association with elevated pulse rate for prediction of mortality – consequences of mental strain? J Intern Med 2001; 250: 521–529. Objectives. Sleep deprivation has experimentally been shown to adversely influence glucose metabolism, endocrine function and sympathovagal balance in young men without known serious disease. We investigated the impact of sleep problems and resting heart rate in a large sample of self‐reported, healthy middle‐aged men and women on long‐term mortality. Methods. In all 22 444 men and 10 902 women participated in a population‐based health screening (71% mean attendance), including blood sampling and examination of blood pressure (BP) and pulse rate after 10 min supine rest, as well as a self‐administered questionnaire on sleep problems. Mortality was assessed from national death registers. Results. Sleep disturbances were related to increased cardiovascular risk factor levels at baseline in both sexes, and predicted total and cause‐specific mortality after a mean of 12 years (women) and 17 years (men) of follow‐up. In men, self‐reported healthy at baseline, total mortality during follow‐up was independently predicted by both sleep problems and increased resting heart rate, also after adjustment for smoking, body mass index (BMI), systolic BP, cholesterol, smoking and problematic alcohol drinking habits. A step‐wise increased total mortality was shown in men reporting successively worse sleep problems and higher heart rate, highest hazard ratio 2.7 [95% confidence interval (CI)=2.1–3.4] after adjustments, compared with men free from sleep problems and with normal heart rate. Conclusions. Sleep disturbance is a predictor of total and cause‐specific mortality in both sexes, but only interacts with increased resting heart rate for this prediction in healthy men. Sleep problems correlated cross‐sectional with disturbances in lipid and glucose metabolism, even after adjustment for degree of obesity and smoking. Sleep disturbance is a symptom for a biological pathway that is correlated to premature mortality. One possible explanation would be that it acts in concert with sympathetic nervous activation (SNA), both being consequences of chronic stress exposure.
Microalbuminuria, cardiovascular disease and risk factors in a nondiabetic/nonhypertensive population. The Nord‐Trøndelag Health Study (HUNT, 1995–97), Norway
Authors: Romundstad S. , Holmen J. , Hallan H. , Kvenild K. , Krüger Ø. , Midthjell K. 
Published: March 2003

Abstract. Romundstad S, Holmen J, Hallan H, Kvenild K, Krüger Ø, Midthjell K (HUNT Research Centre, Verdal, Norway; Levanger Hospital, Levanger, Norway; and Nærøy Health Centre, Nærøy, Norway). Microalbuminuria, cardiovascular disease and risk factors in a nondiabetic/nonhypertensive population. The Nord‐Trøndelag Health Study (HUNT, &1995–97), Norway. J Intern Med 2002; 252: 164–172.Objective.  Microalbuminuria (MA) as an independent marker of cardiovascular morbidity and mortality in nondiabetic/nonhypertensive individuals is under international debate. The aim of this study was to investigate the associations between MA and known cardiovascular risk factors/markers and disease in a randomly selected nondiabetic/nonhypertensive sample.Design.  Cross‐sectional study.Setting.  Participants in the population‐based Nord‐Trøndelag Health Study (HUNT), Norway (n = 65 258).Subjects.  A total of 2113 individuals (≥20 years), randomly selected without diabetes and treated hypertension, delivered three morning urine samples for MA analysis.Main outcome measures.  MA expressed as albumin‐to‐creatinine ratio (ACR), cardiovascular risk factors and disease.Results.  Increasing age, pulse pressure, systolic (SBP) and diastolic blood pressure (DBP) and coronary heart disease (CHD) significantly predicted MA in men and increasing pulse pressure, SBP and DBP were associated with MA in women, adjusted for other cardiovascular risk factors/markers. After excluding individuals with known CHD and untreated hypertension (SBP ≥ 140 mmHg, DBP ≥ 90 mmHg) and hence a high total risk of cardiovascular disease (CVD), only increasing age was associated with ACR in men and increasing SBP and pulse pressure in women. Smoking, elevated lipid and glucose levels were strongly associated with MA in individuals with a high total risk of CVD than in individuals with a low total risk.Conclusion.  MA was associated with increasing blood pressure in both genders, age and CHD in men. Other cardiovascular risk factors/markers might be more influential in predicting ACR variation in nondiabetic/nonhypertensive individuals with a high total risk of CVD than in individuals with a low total risk.
Trends in sudden cardiac death in the northern Sweden MONICA area 1985–99
Authors: Messner T. , Lundberg V. 
Published: March 2003

Abstract. Messner T, Lundberg V (Kiruna District Hospital, Kiruna; Kalix District Hospital, Kalix; Umeå University Hospital, Umeå, Sweden). Trends in sudden cardiac death in the northern Sweden MONICA area 1985–99.J Intern Med2003;253:320–328.Objectives. To describe time trends in sudden cardiac death (SCD) occurrences between 1985 and 1999.Design. Cohort study with analysis of a database of all symptomatic and/or fatal acute myocardial infarctions (AMI) in the two northernmost counties in Sweden, partly north of the Arctic Circle.Subjects. A total of 1139 cases of SCD amongst men and women aged 35–64 years.Main outcome measure. Sudden cardiac death.Results. Amongst men the proportion of SCD to all AMI deaths (within 28 days of an AMI) was 38% and for women 31%. The mean yearly incidence of SCD in this age group was 65 per 100 000 men and 12 per 100 000 women. Amongst men the mean yearly incidence decreased by 1.8% (95% confidence interval −3.2 to −0.3) and amongst women the decrease was 1.0% (95% confidence interval −4.4 to 2.4). Diabetes mellitus was more common in women compared with men (24% vs. 14%,P = 0.001). Men suffered an SCD more often around noon and on Saturdays, whereas women suffered their SCD on Mondays and Fridays. For season, men and women behaved similarly with a winter peak, although statistical significance was reached only for men.Conclusions. The SCD decreased amongst men between 1985 and 1999. There was also a decrease amongst women during the same time period but not to a statistically significant degree, possibly caused by lack of statistical power due to small numbers.
Elevation of biochemical markers for myocardial damage prior to hospital admission in patients with acute chest pain or other symptoms raising suspicion of acute coronary syndrome
Authors: Svensson L. , Axelsson C. , Nordlander R. , Herlitz J. 
Published: March 2003

Abstract.  Svensson L, Axelsson C, Nordlander R, Herlitz J (South Hospital, Stockholm; and Sahlgrenska University Hospital, Göteborg; Sweden). Elevation of biochemical markers for myocardial damage prior to hospital admission in patients with acute chest pain or other symptoms raising suspicion of acute coronary syndrome. J Intern Med 2003; 253: 311–319.Objectives.  To evaluate the occurrence of elevation of serum biochemical markers for myocardial damage in the prehospital setting amongst patients who called for an ambulance due to a suspected acute coronary syndrome (ACS).Design.  Prospective observational study.Subjects.  All the patients who called for an ambulance due to suspected ACS.Setting.  South Hospital's catchment area in Stockholm and in the Municipality of Göteborg, Sweden between January and November in the year 2000, were included.Interventions.  On arrival of the ambulance crew, a blood sample was drawn for bedside analysis of serum myoglobin, creatine kinase MB and troponin I. A 12‐lead electrocardiogram (ECG) was simultaneously recorded.Main outcome measures.  Elevation of biochemical markers prior to hospital admission.Results.  In all, 511 patients participated on 538 occasions. Elevation of any biochemical marker was observed in 11% of all patients. The corresponding figure for patients developing myocardial infarction was 21%; for patients with myocardial ischaemia 8%; for patients with a possible myocardial ischaemia 4% and for patients with other diagnoses 5%. Amongst those who had a final diagnosis of acute myocardial infarction (AMI), 47% had ST‐elevation on initial ECG and 57% had either ST‐elevation or elevation of any biochemical marker.Conclusion.  Bedside analysis of biochemical markers in serum is already feasible prior to hospital admission amongst patients with a suspected ACS. About 20% of patients with AMI have elevated biochemical markers at that stage. When found this data might increase the possibility of diagnosing an AMI very early in the course. However, false positives were found and whether this strategy will improve the triage of these patients in the prehospital setting remains to be proven.
Extrapolation of reciprocal creatinine plot is not reliable in predicting the onset of dialysis in patients with progressive renal insufficiency
Authors: Szeto C.‐C. , Leung C.‐B. , Wong T. Y.‐H. , Chow K.‐M. , Wang A. Y.‐M. , Lui S.‐F. , Li P. K.‐T. 
Published: March 2003

Abstract.  Szeto C.‐C, Leung C.‐B, Wong T.Y.‐H, Chow K.‐M, Wang A.Y.‐M, Lui S.‐F, Li P.K.‐T (Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China). Extrapolation of reciprocal creatinine plot is not reliable in predicting the onset of dialysis in patients with progressive renal insufficiency. J Int Med 2003; 253: 335–342.Background.  Reciprocal creatinine plot is often used to monitor patients with progressive renal insufficiency and to predict the onset of dialysis, although the latter practice has not been validated.Objective.  We examined whether extrapolating the reciprocal creatinine plot can predict the onset of dialysis.Setting.  Single centre study in the dialysis unit of a University teaching hospital.Design.  We studied 170 consecutive patients with progressive renal insufficiency referred to a single nephrology unit and subsequently dialysed. Reciprocal creatinine plot was constructed by all available serum creatinine values before dialysis (the ‘definitive plot’). Four ‘interim plots’ were constructed for each patient by using serum creatinine below 400, 500, 600 and 700 μmol L−1. Interim plots with at least five points and Pearson's r > 0.9 were analysed. The date of dialysis was predicted from the least squares linear regression formula and a target serum creatinine level cor‐ responding to estimated creatinine clearance of 7 mL min−1, at which dialysis was recommended.Results.  The median duration of observation was 25 months. After serum creatinine 500 μmol L−1, the slope of the interim plot remained stable and extrapolation was possible in 117 patients (68.8%). However, the limits of agreement for predicting the onset of dialysis were wide (from −11.7 to +9.5 months). At this creatinine level, the onset of dialysis fell within 1 month of the predicted onset in only 41 patients (24.1%). The limits of agreement for prediction narrowed when time points of higher serum creatinine were included into the plot. However, nine patients (5.3%) required dialysis within 1 month at creatinine 600 μmol L−1 and the dialysis was not predicted by the reciprocal creatinine plot. Target serum creatinine did not correlate with acute serum creatinine at which dialysis was started (r = 0.051, P = 0.51). A slower decline in renal function was associated with a higher prediction error (r = 0.212, P = 0.014).Conclusions.  The onset of dialysis cannot be predicted by extrapolation of the reciprocal creatinine plot because of individual variation in the renal function that require dialysis. Dialysis would be almost imminent in some patients by the time serum creatinine reaches a level that allows accurate construction and extrapolation of a plot.