bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insulin‐like growth factor‐I lowers fasting and postprandial triglyceride levels without affecting chylomicron clearance in healthy men
Authors: Bianda T. , Zapf J. , Froesch E. R. , Schmid C. 
Published: March 2003

Abstract. Bianda T, Zapf J, Froesch ER, Schmid C (University Hospital, Zürich, Switzerland). Insulin‐like growth factor‐I lowers fasting and postprandial triglyceride levels without affecting chylomicron clearance in healthy men. J Intern Med 1999; 245: 455–462.Objectives. To study whether IGF‐I treatment alters the postprandial lipid and lipoprotein metabolism.Design. Randomized, crossover study.Setting. University Hospital, Zürich, Switzerland.Subjects. Seven young healthy male subjects (aged 27 ± 4 years, body mass index (BMI) 21.8 ± 1.7 kg m–2).Interventions. Each subject was studied two times at 2‐week intervals, treated with saline 0.9% (S) and IGF‐I (8 µg kg–1 h–1) by a continuous subcutaneous infusion. 60 h after the start of treatment a vitamin A loading test was performed after an overnight 12‐h fast.Main outcome measures. Glucose, insulin, total and free IGF‐I, FFA, triglycerides and retinyl palmitate, total cholesterol, HDL and LDL cholesterol, lipoprotein (a) and apolipoprotein B were measured in serum before and after the fatty meal.Results. Total IGF‐I levels rose from 29.0 ± 3.3 nmol L–1 to 113.3 ± 9.0 nmol L–1 (P < 0.02) and free IGF‐I from 0.24 ± 0.05 to 1.08 ± 0.28 nmol L–1 (P < 0.02) during IGF‐I treatment. IGF‐I administration reduced insulin concentrations by 50% (P < 0.02), as assessed by the area under the curve. Serum triglyceride levels were significantly lower at baseline and after the fat load during IGF‐I treatment (P < 0.02), whereas the retinyl palmitate concentrations in chylomicron and nonchylomicron lipoprotein fractions were similar during both treatment periods.Conclusions. IGF‐I treatment reduces the triglyceride levels most probably by decreasing insulin secretion and the production of VLDL particles, and possibly by increasing their turnover. IGF‐I treatment has no significant effect on the metabolism of intestine‐derived triglyceride‐rich lipoproteins after a high fat meal in healthy young men.
The measurement of venous haematocrit in patients with polycythaemia vera
Authors: Andréasson B. , Wahlström E. , Jacobsson S. , Björkholm M. , Samuelsson J. , Birgegård G. , Wadenvik H. , Kutti J. 
Published: March 2003

Abstract. Andréasson B, Wahlström E, Jacobsson S, Björkholm M, Samuelsson J, Birgegård G, Wadenvik H, Kutti J (Medical Clinic, Kärnsjukhuset, Skövde; Sahlgrenska University Hospital, Göteborg; Karolinska Hospital, Stockholm; Huddinge University Hospital, Huddinge; and Akademiska Hospital, Uppsala, Sweden). The measurement of venous haematocrit in patients with polycythaemia vera. J Intern Med 1999; 246: 293–297.Objective. In clinical practice, patients with polycythaemia vera (PV) are monitored by measurement of venous packed cell volume (PCV). However, whereas treatment recommendations are still based upon studies in which the results were obtained with the centrifuged microhaematocrit, currently in most instances automated blood cell counters are used to calculate PCV. In a group of patients with polycythaemia we therefore compared the results obtained by the microhaematocrit method with PCV calculated by haematology analysers.Design. The study was carried out on a prospective basis. Duplicate venous blood samples were collected. The centrifuged microhaemotocrit was obtained by using an IEC Micro‐MB Centrifuge. Depending on different routine methods used in the participating hospitals, the blood cell counter PCV was calculated using Coulter STKS, Bayer Technicon H2 or H3.Setting. Patients were included from four Swedish university hospitals: Akademiska (Uppsala), Huddinge and Karolinska (Stockholm) and Sahlgrenska (Göteborg).Subjects. Seventy‐four patients with PV and 10 patients with secondary polycythaemia were included and a total of 150 duplicate blood samples were analysed from these subjects.Results. In the 150 measurements the mean blood cell counter calculated PCV was 0.448 ± 0.037; the mean for centrifuged microhaematocrit was 0.467 ± 0.037 and the difference between means was highly significant (P = 6.8 × 10–25). The means for centrifuged haematocrit and calculated PCV differed significantly in the groups of PV patients treated with phlebotomy only, hydroxyurea or radiophosphorous (P < 0.0001, respectively). In PV patients treated with α‐interferon and in patients with secondary polycythaemia the difference in means did not reach statistical significance (P = 0.07 and P = 0.13, respectively). The groups of patients with MCV <80 fL and ≥80 fL both presented significant differences between means for calculated PCV and centrifuged haematocrit.Conclusions. If PV patients are monitored with blood cell counter calculated PCV it appears that the therapeutic goal should be to maintain the calculated PCV below 0.43, provided the local differences in calculated PCV and centrifuged haematocrit are of the same magnitude as in this study.
Autoimmunity and extranodal lymphocytic infiltrates in lymphoproliferative disorders
Authors: JØNSSON V. , WIIK A. , HOU‐JENSEN K. , CHRISTIANSEN M. , RYDER L. P. , MADSEN H. O. , GEISLER C. , HANSEN M. M. , THOMSEN K. , VORSTRUP S. , SVEJGAARD A. 
Published: March 2003

Abstract. Jønsson V, Wiik A, Hou‐Jensen K, Christiansen M, Ryder LP, Madsen HO, Geisler C, Hansen MM, Thomsen K, Vorstrup S, Svejgaard A (Rigshospital, University of Copenhagen and State Serum Institute, Copenhagen, Denmark). Autoimmunity and extranodal lymphocytic infiltrates in lymphoproliferative disorders. J Intern Med 1999; 245: 277–86.Objective. To examine the relationship between autoimmunity and extranodal lymphocytic infiltrates in different lymphoproliferative disorders with immunoglobulin alterations.Subjects and design. A clinical review combined with a retrospective cohort study of 380 patients, 28 with monoclonal gammopathy of undetermined significance, three with common variable immunodeficiency, 147 with chronic lymphocytic leukaemia, 57 with Waldenström's macroglobulinaemia and 145 with non‐Hodgkin's malignant lymphoma.Setting. A university hospital and The State Serum Institute in Copenhagen.Intervention. Clinical examination of each patient with special attention to chronic inflammatory and autoimmune manifestations. Biopsies were taken from non‐infectious infiltrates, some of which were additionally tested with PCR analysis for gene rearrangements. Serological screening with a test battery for various autoantibodies was used in combination with techniques for the detection of M‐components and monoclonal B‐cell proliferation.Main outcome measures. Clinical and/or serological autoimmune manifestations, M‐component and other immunoglobulin alterations, and inflammatory tissue changes were studied in patients with chronic inflammatory, polyclonal or oligoclonal pseudolymphomas and in monoclonal, malignant extranodal lymphomas.Results. In 380 consecutive patients, 49 (12.9%) had extranodal manifestations, of whom 47 also had autoimmune manifestations. Nearly half of the 47 patients had more than one autoimmune manifestation. There was a strong correlation between clinical signs and corresponding autoantibodies such as anti‐SSA and ‐SSB antibodies in Sjögren's syndrome (10 cases), antithyroid peroxidase antibodies in thyroiditis and Graves' disease (10 cases), and parietal cell antibodies in gastric ulcers with maltoma (12 cases). Clinical and serological signs of autoimmunity correlated strongly with female sex (34, 72% women; and 13, 28% men) and with immunoglobulin alterations.Conclusions. To our knowledge this is the first systematic review of B‐lymphoproliferative and autoimmune disorders indicating that pseudolymphoma and malignant lymphomas, including maltomas, may develop in the context of a permanent autoantigenic drive.
Sickle cell‐like crisis and bone marrow necrosis associated with parvovirus B19 infection and heterozygosity for haemoglobins S and E
Authors: Eichhorn R. F. , Buurke E. J. , Blok P. , Berends M. J. H. , Jansen C. L. 
Published: March 2003

Abstract.In the literature, heterozygosity for haemoglobins S and E is known as a clinically benign condition. Nevertheless, we present a case of double heterozygosity manifesting as an infarctive sickle cell‐like crisis with acute chest syndrome and reversible bone marrow necrosis. Importantly, these complications were associated with serologically documented parvovirus B19 infection. Reviewing the literature, this case emphasizes a specific role of parvovirus B19 as a precipitating cause. Furthermore, it demonstrates how important the consideration of haemoglobin disorders can be even outside of the historically known areas.
Predicting the outcome of invasive treatment of renal artery disease
Authors: Helin K. H. , Lepäntalo M. , Edgren J. , Liewendahl K. , Tikkanen T. , Tikkanen I. 
Published: March 2003

Abstract. Helin KH, Lepäntalo M, Edgren J, Liewendahl K, Tikkanen T, Tikkanen I (Helsinki University Hospital, Helsinki, Finland). Predicting the outcome of invasive treatment of renal artery disease. J Intern Med 2000; 247: 105–110.Objective. Analysis of the factors influencing the outcome of performed or attempted invasive treatment for renal artery disease (RAD).Setting. University Hospital.Study patients. Thirty‐five hypertensive patients with 31 stenoses and 14 occlusions of renal artery.Interventions. Angioplasty was performed on 25 patients (attempted for 30), primary stenting on one, nephrectomy on three, and renal resection on one patient.Main outcome measure. A decrease of diastolic blood pressure (DBP) by ≥15 mmHg after intervention.Results. A DBP response was seen in 24 patients. In 11 patients, invasive treatment did not result in a DBP response or failed technically. Compared with these patients, the responders were younger (55 ± 11 vs. 66 ± 8 years, P = 0.001) and tended to have higher DBP (100 ± 8 vs. 93 ± 11 mmHg, P = 0.065). The function of the affected kidney, or that of the more affected kidney if RAD was bilateral, was better preserved in responders (relative clearance on captopril renography 23 ± 15 vs. 8 ± 4%, P = 0.008). A response was more often seen in unilateral than in bilateral RAD (81% vs. 33%, P = 0.015). A relative clearance of ≤10% on captopril renography had sensitivity of 88% and specificity of 81% for renal artery occlusion. Step‐wise logistic analysis. (1) When DBP was< 95 mmHg with two antihypertensives, the response rate was 1/6 vs. 24/29 for more severe hypertension (P = 0.004). (2) Elderly patients had a response rate of 2/5 vs. 22/24 in younger patients (P = 0.024). (3) Response rates in bilateral and unilateral disease were not different, nor did the function of the affected kidney impact the DBP response. However, three of the four responders with ≤10% relative clearance had an occluded renal artery and underwent nephrectomy.Conclusions. Middle‐aged patients with easily controlled hypertension and elderly hypertensives do not usually have a blood pressure response to the performed or attempted invasive treatment of RAD. Therefore, it seems recommendable not to screen such patients for RAD, unless their renal function is deteriorated. If the affected kidney functions poorly on captopril renography, angioplasty is usually not applicable and seldom leads to a blood pressure response.
Hormone replacement therapy in healthy postmenopausal women. Effects on intraplatelet cyclic guanosine monophosphate, plasma endothelin‐1 and neopterin
Authors: Anwaar I. , Rendell M. , Gottsäter A. , Lindgärde F. , Hulthén U. L. , Mattiasson I. 
Published: March 2003

Abstract. Anwaar I, Rendell M, Gottsäter A, Lindgärde F, Hulthén UL, Mattiasson I (University of Lund, University Hospital, Malmö, Sweden). Hormone replacement therapy in healthy postmenopausal women. Effects on intraplatelet cyclic guanosine monophosphate, plasma endothelin‐1 and neopterin. J Intern Med 2000; 247: 463–470.Objectives. To evaluate beneficial effects of postmenopausal hormone replacement therapy (HRT) on endothelial function, measured as intraplatelet cyclic guanosine monophosphate (cGMP, mediator of nitric oxide), cyclic adenosine monophosphate (cAMP, mediator of prostacyclin) and plasma endothelin‐1 (ET‐1), and on monocyte activation, measured as plasma neopterin.Design. Part 1: double‐blind randomized trial for 3 months; part 2: open study for 9 months.Setting. The study was performed at the Department of Endocrinology, University Hospital, Malmö, Sweden.Subjects. Fifty‐one postmenopausal women participated in part 1 and 46 in part 2. Inclusion criteria included a history of amenorrhoea for at least 6 months before the study and body mass index ≥ 24 kg m–2.Intervention. Randomization for either placebo (n = 24) or HRT (n = 27). HRT was given as 2 mg oestradiol valerate for the first 3 months with the addition of 10 mg medroxyprogesterone for 10 days every third month thereafter.Measurements. Performed at baseline and after 3 and 12 months of the study.Results. In the HRT group, intraplatelet cGMP increased from 0.56 (0.35–0.94) to 0.61 (0.42–3.40) and 0.65 (0.43–1.08) pmol (109 platelets)–1 after 3 and 12 months, respectively (P = 0.01), whereas plasma ET‐1 decreased from 3.2 (1.1–6.8) to 2.0 (0.8–5.1) and 1.8 (0.4–15.4) pg mL–1 (P < 0.001). Intraplatelet cAMP and plasma neopterin were unchanged. When smokers (n = 15) and non‐smokers (n = 12) in the HRT group were analysed separately, significant effects were seen only amongst smokers. The control group showed unchanged levels of cGMP, cAMP, ET‐1 and neopterin.Conclusions. These data suggest beneficial effects of HRT on endothelial function which may account for anti‐atherogenic effects of HRT in postmenopausal women, especially in smokers. No effects of HRT were seen upon monocyte activation.
Acute respiratory failure associated with catastrophic antiphospholipid syndrome
Authors: Wiedermann F. J. , Mayr A. , Schobersberger W. , Knotzer H. , Sepp N. , Rieger M. , Hasibeder W. , Mutz N. 
Published: March 2003

Abstract. Wiedermann FJ, Mayr A, Schobersberger W, Knotzer H, Sepp N, Rieger M, Hasibeder W, Mutz N (The Leopold‐Franzens‐University of Innsbruck, Innsbruck, Austria). Acute respiratory failure associated with catastrophic antiphospholipid syndrome (Case Report). J Intern Med 2000; 247: 723–730.We present a case of multiple organ dysfunction syndrome with acute respiratory failure due to alveolar haemorrhage associated with antiphospholipid antibodies in a 42‐year‐old woman with a medical history of antinuclear antibody‐negative systemic lupus erythematosus and antiphospholipid syndrome. Severe respiratory failure, circulatory shock and acute renal failure necessitated artificial ventilation, inotropic and vasopressor therapy, and continuous venovenous haemofiltration. A tentative diagnosis of haemorrhagic lupus pneumonitis or pulmonary manifestation of antiphospholipid syndrome was made. Lupus anticoagulant, IgG anticardiolipin and anti‐β2‐glycoprotein I antibodies were positive. High‐dose glucocorticoid, anticoagulation with heparin, plasmapheresis and cyclophosphamide improved her clinical condition. Despite this, the patient died several days later of spontaneous intracranial haemorrhage. This case illustrates the uncommon manifestation of acute respiratory failure associated with antiphospholipid syndrome.
Does dialysis therapy improve autonomic and peripheral nervous system abnormalities in chronic uraemia?
Authors: Laaksonen S. , Voipio‐Pulkki L.‐M. , Erkinjuntti M. , Asola M. , Falck B. 
Published: March 2003

Abstract. Laaksonen S, Voipio‐Pulkki L‐M, Erkinjuntti M, Asola M, Falck B (University Hospital, Turku, Finland). Does dialysis therapy improve autonomic and peripheral nervous system abnormalities in chronic uraemia? J Intern Med 2000; 248: 21–26.Objectives. Autonomic nervous system (ANS) dysfunction and peripheral neuropathy occur in patients with chronic renal insufficiency. Adequate renal replacement therapy should prevent development or correct these abnormalities.Design and subjects. We studied retrospectively ANS and peripheral neuropathy in 32 patients with chronic uraemia who received either haemodialysis (16) or peritoneal dialysis (16) therapy, and compared the observed dialysis efficiency with changes in neurological function.Methods. Heart rate variability (HRV) time domain indices and peripheral sensory nerve conduction studies were followed for a mean of 2.9 years. The adequacy of haemodialysis (HD) efficiency was estimated by Kt/V, an index of fractional urea clearance. Adequacy of continuous ambulatory peritoneal dialysis (CAPD) was estimated on the basis of the patient’s wellbeing and nutritional status as excellent, satisfactory or poor. Based on observed changes in HRV time domain measures, the observations were divided in three subgroups: improved, unchanged or deteriorated.Results. The peripheral sensory nerve conduction studies were abnormal in 38% of the patients and did not change significantly during the study. Improvement in HRV time domain measures occurred in HD patients with mean Kt/V > 1.20 or in CAPD patients with satisfactory or excellent response to dialysis treatment. Values of Kt/V < 0.85 in HD patients were associated with progressive deterioration of autonomic neuropathy. Diabetic patients (n = 4) differed from others as their HRV was grossly abnormal and did not improve.Conclusions. The adequacy of haemodialysis is a predictor of improvement of cardiac autonomic nervous function in chronic uraemia. The same trend of improvement was seen also in CAPD patients.
Cigarette smoking, oral moist snuff use and glucose intolerance
Authors: Persson P.‐G. , Carlsson S. , Svanström L. , Östenson C.‐G. , Efendic S. , Grill V. 
Published: March 2003

Abstract. Persson P‐G, Carlsson S, Svanström L, Östenson C‐G, Efendic S, Grill V (Karolinska Hospital and Karolinska Institutet, Stockholm, Sweden). Cigarette smoking, oral moist snuff use and glucose intolerance. J Intern Med 2000; 248: 103–110.Objective. To investigate the association between cigarette smoking and use of oral moist snuff and impaired glucose tolerance and type 2 diabetes.Design. We performed a population‐based cross‐sectional study of glucose intolerance and tobacco use in Stockholm during 1992–94. The sample consisted of 3128 men, aged 35–56 years, of whom 52% had a family history of diabetes. In an oral glucose tolerance test, we detected 55 men with type 2 diabetes and 172 with impaired glucose tolerance. Information on cigarette smoking and oral moist snuff use was collected by a questionnaire.Results. The odds ratio of type 2 diabetes was increased for smokers of 25+ cigarettes day–1 (odds ratio = 2.6, 95% confidence interval = 1.1–5.9) as well as for moist snuff dippers of 3+ boxes week–1 (odds ratio = 2.7, 95% confidence interval = 1.3–5.5). The odds ratio of relatively high (highest tertile) fasting insulin levels in subjects with impaired glucose tolerance associated with cigarette smoking of 25+ cigarettes day–1 was 1.5 (95% confidence interval = 0.7–3.6). The corresponding estimate of a relatively low (lowest tertile) 2 h insulin response was 2.5 (95% confidence interval = 0.9–7.1).Conclusions. These results indicate that heavy users of cigarettes or moist snuff have an increased risk of type 2 diabetes. The results could suggest that tobacco use is associated with a low insulin response.
The effect of different treatment regimens in reducing fasting and postmethionine‐load homocysteine concentrations
Authors: Van Der Griend R. , Biesma D. H. , Haas F. J. L. M. , Faber J. A. J. , Duran M. , Meuwissen O. J. A. TH. , Banga J.‐D. 
Published: March 2003

Abstract. van der Griend R, Biesma DH, Haas FJLM, Faber JAJ, Duran M, Meuwissen OJATh, Banga J‐D (Sint Antonius Hospital, Nieuwegein; University of Utrecht, Utrecht; and the University Medical Center Utrecht, The Netherlands). The effect of different treatment regimens in reducing fasting and post‐methionine‐load homocysteine concentrations. J Intern Med 2000; 248: 223–229.Objectives. To determine the homocysteine‐lowering effect of different treatment regimens on both fasting and postmethionine‐load plasma total homocysteine (tHcy) concentrations.Design. Descriptive study of consecutive hyperhomocysteinaemic subjects per treatment regimen. Homocysteine was measured in the fasting state and 6 h after methionine loading, both before and after 8 weeks of vitamin therapy. Hyperhomocysteinaemia was defined as a fasting tHcy and/or increase in tHcy (postmethionine‐load minus fasting tHcy concentration) exceeding the 95th percentile of local controls.Setting. Outpatient clinic of internal medicine of a large non‐academic teaching hospital.Subjects. One hundred and seventeen hyperhomocysteinaemic subjects (vascular patients and first‐degree relatives).Interventions. There were four regimens: pyridoxine, 200 mg; folic acid, 5 mg; combination of folic acid 0.5 mg and pyridoxine 100 mg; and folic acid, 0.5 mg daily.Results. All regimens, except pyridoxine 200 mg, significantly reduced fasting tHcy without differences in the percentage reduction (32–38%). All regimens produced a significant reduction in the increase in tHcy and postmethionine‐load tHcy. The reduction in postmethionine‐load tHcy was smaller for pyridoxine 200 mg than for combination therapy. No differences were found in the percentage reduction (for both increase in tHcy and postmethionine‐load tHcy) between folic acid 5 mg and folic acid 0.5 mg.Conclusions. Monotherapy folic acid (0.5 mg daily) is the lowest effective therapy for reducing both fasting and postmethionine‐load tHcy concentrations, with the same results as high‐dose folic acid (5 mg daily). Pyridoxine has no additional value.
Primary biliary cirrhosis: survival of a cohort followed for 10 years
Authors: Uddenfeldt P. , Danielsson Å. 
Published: March 2003

Abstract. Uddenfeldt P, Danielsson Å (County Hospital Gävle and University Hospital Umeå, Sweden). Primary biliary cirrhosis: survival of a cohort followed for 10 years. J Intern Med 2000; 248: 292–298.Objectives. To study the natural course of primary biliary cirrhosis (PBC) in order to be able to design accurate clinical pharmacological studies and evaluate the need for liver transplantation.Design. A cohort of 86 patients with PBC living in northern Sweden was followed for a 10‐year period during 1983–93. No patients received therapy with ursodeoxy cholic acid or other drugs during the follow‐up period.Method. At start all patients were investigated personally by the authors. At follow‐up medical notes were scrutinized and special questionnaires to the current responsible physician were applied. End‐points were the time of dropout, liver transplantation, death or end of the study period.Results. At follow‐up data were available for 84 patients (97%). During the study period 34 patients died, of whom 28 were symptomatic; 15 deaths had no direct connection to PBC. Nineteen deaths were related to PBC of whom two were asymptomatic, the most common cause being end‐stage liver disease with liver coma. During the study period in all eight patients were subjected to liver transplantation.Conclusions. The survival rate of the 32 asymptomatic PBC patients at the start of the study
was the same as a sex‐ and age‐matched standard background population. Those patients with symptomatic PBC from the beginning of study had a survival rate at 10 years of 50%, and the most ominous sign was a bilirubin greater than 35 µmol
L−1. Liver transplantation was performed in almost 10% in this cohort until 1993. Since then, the indications and referral practice for liver transplantation has changed and is now higher.