bluuebunny/crossref_metadata_2025_split huggingface dataset:
Under‐reporting of dietary intake by smoking and non‐smoking subjects counselled for hypercholesterolaemia
Authors: Tonstad S. , Gørbitz C. , Sivertsen M. , Ose L. 
Published: March 2003

Abstract.Objectives.  We asked whether under‐reporting of energy and cigarette smoking were associated with choice of foods and dietary composition amongst subjects with hypercholesterolaemia who had received dietary instruction to lower serum cholesterol.Design, setting and subjects.  Dietary intake was assessed with a 4‐day weighed food record in 205 women and 141 men, aged 20–73 years, being treated at a lipid clinic (tertiary referral centre). Under‐reporting was assessed by calculating the ratio of energy intake (EI) to estimated basal metabolic rate (BMR).Results.  The median EI/BMR was 1.1 for both men and women. EI/BMR did not differ according to smoking status, but correlated negatively with body mass index (Spearman’s ρ = –0.32, P = 0.0001). EI/BMR was inversely associated with energy‐adjusted intakes of potatoes, vegetables, fish and low‐fat meats, and positively associated with intakes of nuts, potato crisps, chocolate, sour and ice cream, oils, fatty meat spreads, cakes and biscuits, and with alcohol. Thus, low EI/BMR was associated with increased energy‐adjusted intakes of protein, thiamine, riboflavin, niacin, iron and cholesterol and with decreased intakes of sugar, poly‐ and monounsaturated fats and vitamin E (all P < 0.05). Cigarette smokers had a higher energy percentage (E%) from fat than non‐smokers (29 ± 6 vs. 26 ± 6), a lower E% from carbohydrates (50 ± 7 vs. 54 ± 7) and a lower intake of vitamin C (11 ± 7 vs. 16 ± 9 mg MJ–1; all P = 0.0001), reflecting an increased intake of fatty meats and a decreased intake of skimmed cheese, fruit, rice and pasta, and cakes and biscuits (all P < 0.05).Conclusion.  Weighed dietary records reflected a ‘healthier’ intake of fat, protein, sugar, alcohol and some micronutrients amongst under‐reporters, suggesting that self‐reported dietary intakes are biased in patients with hypercholesterolaemia. Lack of responsiveness to the diet should not be assumed when dietary data are based on self‐report. Smokers report a higher intake of fat and lower intake of vitamin C than non‐smokers, even after dietary counsel, and may require more intensive interventions to optimize the diet.
Genetics of human obesity: lessons from mouse models and candidate genes
Authors: Echwald S. M. 
Published: March 2003

Abstract. Echwald SM (Steno Diabetes Centre and Hagedorn Research Institute, Gentofte, Denmark). Genetics of human obesity: lessons from mouse models and candidate genes. (Minisymposium: Genes & Obesity). J Intern Med 1999; 245: 653–666.Obesity is a common disorder with potentially serious negative implications on health and quality of life and a rising prevalence worldwide, warranting effective treatments. The disorder runs in families, and important knowledge is expected to follow the identification of human obesity genes. Although statistical analysis of inheritance of obesity in humans suggests a large genetic component in obesity, up to 80%, few actual obesity genes have been identified so far. However, a number of obesity causing genes have successfully been cloned from rodents with monogenic forms of obesity, and it is probable that new knowledge in the field of human obesity will result from these findings.
Improvement in quality of life differs between women and men after coronary artery bypass surgery
Authors: Sjöland H. , Wiklund I. , Caidahl K. , Hartford M. , Karlsson T. , Herlitz J. 
Published: March 2003

Abstract. Sjöland H, Wiklund I, Caidahl K, Hartford M, Karlsson T, Herlitz J (Sahlgrenska University Hospital, Göteborg, and Astra Hässle AB, Mölndal, Sweden). Improvement in quality of life differs between women and men after coronary artery bypass surgery. J Intern Med 1999; 245: 445–454.Objective. To study improvement in quality of life (QoL) after coronary artery bypass grafting (CABG) in relation to gender.Background. Women generally report worse QoL after CABG than men. However, women are older and more symptomatic prior to surgery, which should be considered in comparative analyses.Methods. We studied consecutive patients who underwent CABG between 1988 and 1991 [n = 2121] with a QoL questionnaire containing the Physical Activity Score, the Nottingham Health Profile and the Psychological General Well‐being Index prior to, 3 months, 1 year and 2 years after surgery.Results. Females were older than men with more concomitant diseases preoperatively. QoL was improved on all postoperative occasions for both sexes. Improvement in the Physical Activity Score was somewhat, although not significantly, greater in males. Improvement in the Nottingham Health Profile was greater in females. General well‐being showed no consistent pattern for improvement.Conclusions. QoL is significantly improved after CABG in both sexes throughout follow‐up. There is a complex association between improvement in various aspects of QoL and gender.
Ventricular arrhythmias during 24‐h ambulatory ECG recording: incidence, risk factors and prognosis in men with and without a history of cardiovascular disease
Authors: Engström G. , Hedblad B. , Janzon L. , Juul‐Möller S. 
Published: March 2003

Abstract.Engström G, Hedblad B, Janzon L, Juul‐Möller S (Malmö University Hospital, Malmö, Sweden). Ventricular arrhythmias during 24‐h ambulatory ECG recording: incidence, risk factors and prognosis in men with and without a history of cardiovascular disease.J Intern Med1999;246:363–372.Objective.To study incidence, prognosis and risk factors of ventricular arrhythmias in men with and without asymptomatic non‐invasively detected cardiovascular disease (CVD).Design.Prospective cohort study with 11 years’ follow‐up. The subjects went through 24‐h ambulatory electrocardiographic (ECG) registrations and non‐invasive examinations of leg and carotid arteries at the baseline examination.Setting.Malmö, Sweden.Subjects.Four hundred and forty‐three randomly selected 68‐year‐old men.Main outcome measures.Mortality and cardiac event rates during an 11‐year period.Results.Frequent or complex arrhythmias (Lown class 2–5) were common in men both with and without CVD. However, the associated prognoses were different. In men with CVD, frequent or complex arrhythmias were associated with increased cardiac event rates (P = 0.001) and increased mortality (P = 0.054). This pattern was also found in men with asymptomatic leg and carotid artery disease, although the frequency of arrhythmia in Lown class 2–5 was similar to that in men without CVD. Men with angina pectoris or previous myocardial infarction in combination with leg or carotid artery disease had the most arrhythmias and the worst prognosis. No relationship between frequent or complex arrhythmias and mortality or cardiac events was found in men without CVD. In a logistic regression, smoking and diabetes mellitus were significant and independent determinants of frequent or complex arrhythmias in men with CVD. High alcohol consumption was associated with arrhythmias in men without CVD.Conclusion.Ambulatory ECG recording is a feasible method to improve risk assessment in men with CVD. In this group, frequent or complex arrhythmias are associated with smoking and diabetes mellitus.
The health care costs of heart failure in Sweden
Authors: Rydén‐Bergsten T. , Andersson F. 
Published: March 2003

Abstract. Rydén‐Bergsten T, Andersson F (AstraZeneca R&D, Lund; and AstraZeneca R&D, Mölndal; Sweden). The health care costs of heart failure in Sweden. J Intern Med 1999; 246: 275–284.Aim. Heart failure is a common and serious condition requiring extensive health care resources. The aim of this study is to estimate the total treatment costs of heart failure in Sweden.Methods and results. The study is a prevalence‐based cost‐of‐illness study. It includes costs of institutional care (hospitals and nursing homes), outpatient care, surgery and drugs. The costs are estimated based on official Swedish statistics, and on various clinical and epidemiological studies. The results are expressed in 1996 prices. The total annual treatment costs for heart failure are approximately Swedish kronor (SEK) 2000–2600 million , or nearly 2% of the Swedish health care budget. Institutional care is the single largest component, amounting to SEK 1300–1900 million , or about 65–75% of the costs of heart failure treatment.Conclusions. The results from this study indicate that heart failure is a costly condition. Efforts to develop effective management programmes that can reduce the need for expensive institutional care, without a negative impact on quality of life, morbidity and mortality, should be given high priority.
Quality of life after cerebrovascular stroke: a systematic study of patients’ preferences for different functional outcomes
Authors: Hallan S. , Åsberg A. , Indredavik B. , Widerøe T. E. 
Published: March 2003

Abstract.Hallan S, Åsberg A, Indredavik B, Widerøe TE (University Hospital of Trondheim, Trondheim, Norway). Quality of life after cerebrovascular stroke: a systematic study of patients’ preferences for different functional outcomes.J Intern Med1999;246:309–316.Objectives.To elicit valid quality of life estimates and the highest acceptable treatment risk of different outcomes after stroke. This is a prerequisite for rational medical decision‐making, especially when considering treatments like thrombolysis.Subjects.Healthy people, non‐stroke medical patients and stroke survivors aged 20–84 years (n = 158)Interventions.Subjects were interviewed by a physician using three different methods (‘standard gamble’, ‘time trade‐off’ and ‘direct scaling’) supported by an interactive computer program.Main outcome measures.We measured utility, a numerical value ranging from 0.00 (death) to 1.00 (perfect health), representing the strength of the patient’s preference for an outcome. When using the standard gamble method, risk is also introduced into the measurement.Results.People’s preferences for stroke outcomes varied widely, and the estimates were influenced by assessment method. We found that previous stroke, marital status and age were the only independent variables influencing the utility given. Subjects in our population over the age of 45 were very comparable to the real population at risk for acute stroke regarding these three variables, and they assigned a median utility of 0.91 (10th percentile, 0.65; 90th percentile, 0.99) to a minor stroke and 0.61 (10th percentile, 0.08; 90th percentile, 0.95) to a major stroke using the standard gamble method.Conclusions.Most people do not feel that suffering from stroke is an overwhelming catastrophe and they do not accept treatment options with very high risks.
Gas chromatographic–mass spectrometric analysis of urinary glycyrrhetinic acid: an aid in diagnosing liquorice abuse
Authors: Kerstens M. N. , Guillaume C. P. F. , Wolthers B. G. , Dullaart R. P. F. 
Published: March 2003

Abstract. Kerstens MN, Guillaume CPF, Wolthers BG, Dullaart RPF (University Hospital Groningen, Groningen, The Netherlands). Gas chromatographic–mass spectrometric analysis of urinary glycyrrhetinic acid: an aid in diagnosing liquorice abuse. J Intern Med 1999; 246: 539–547.Objectives. Liquorice abuse can lead to severe clinical complications, caused by its active compound 18β‐glycyrrhetinic acid (18βGA). 18βGA inhibits dehydrogenase activity of 11β‐hydroxysteroid dehydrogenase (11βHSD). This enzyme catalyses the interconversion between cortisol and cortisone and normally protects the mineralocorticoid receptor from being activated by cortisol. Diagnosing liquorice abuse can be notoriously difficult. The aim of our study was to develop an accurate and clinically applicable 18βGA urinary assay.Design. We developed a urinary 18βGA assay based on gas chromatography and mass spectrometry (GCMS) with sufficient sensitivity to detect 18βGA at low concentrations. The assay was validated in four volunteers consuming different amounts of liquorice. We applied its use in two patients with hypokalaemic hypertension and suppressed plasma renin activity and serum aldosterone, who were suspected of liquorice abuse.Results. The detection limit for 18βGA of the GC assay was 10 µg L–1, which was lowered to 3 µg L–1 by subsequent application of MS. In all volunteers, urinary 18βGA was detected during liquorice intake. Urinary 18βGA remained detectable until 5 days after stopping continued liquorice intake and until at least 51 h after ingestion of a single large amount. Urinary 18βGA was demonstrated in both patients, establishing a diagnosis of liquorice abuse. One patient showed changes in urinary cortisol metabolites, consistent with 11βHSD inhibition. Changes in cortisol metabolites were less pronounced in the other patient.Conclusion. Liquorice abuse can result in hypokalaemic hypertension with prolonged suppression of plasma renin activity and aldosterone concentration. This is caused by 18βGA‐mediated inhibition of 11βHSD, resulting in activation of the renal mineralocorticoid receptor by cortisol. Urinary 18βGA measurement by GCMS is a useful aid in establishing liquorice abuse.
QT interval measurement: Q to TApex or Q to TEnd?
Authors: Davey P. P. 
Published: March 2003

Abstract. Davey PP (John Radcliffe Hospital, Oxford, England, UK). QT interval measurement: Q to TApex or Q to TEnd? J Intern Med 1999; 246: 145–149.Objective. To study QT interval. QT interval is frequently measured, though there is variation in the literature as to whether it is more appropriate to measure from the Q wave to the apex of the T wave, which is methodologically easy, or to measure to the end of the T wave.Hypothesis.
For Q–TApex interval to be used as a measure of repolarization, the variability of the Q–T interval should lie in this early phase. This should be true in health and in disease, at rest and with physiological interventions such as exercise. If there is variability in the TApex –TEnd interval, this should be reflected by the variability in the Q–TApex interval.Methods. Fifty‐six subjects were recruited: 24 with heart failure, 16 with left ventricular hypertrophy and 16 controls. Q–TApex, Q–TEnd and TApex–TEnd intervals were measured at rest and on exercise.Results. Q–T
Apex intervals at rest were not different amongst the three groups studied, being 339 ± 7 ms for controls, 341 ± 6 ms in left ventricular hypertrophy and 351 ± 6 ms in heart failure. The Q–TEnd interval at rest was 421 ± 6 ms in controls, 420 ± 6 ms in hypertrophy and 461 ± 9 ms in failure (P < 0.05 for failure versus hypertrophy or control). Thus the TApex–TEnd interval was prolonged in heart failure at rest. However, at peak exercise there was no difference between the TApex–TEnd intervals in the different groups. Variability in the TApex–TEnd interval induced by disease or by exercise was not related to variability in the Q–TApex interval.Conclusion. Q–T
End rather than Q–TApex should be used when Q–T interval measurement is required.
Psychosocial variables in relation to various risk factors in patients with stable angina pectoris
Authors: Billing E. , Eriksson S. V. , Hjemdahl P. , Rehnqvist N. 
Published: March 2003

Objectives.To evaluate relationships between psychosocial variables and common risk factors such as age, concomitant diseases (hypertension, diabetes mellitus, myocardial infarction, heart failure) and smoking habits in patients with stable angina pectoris.Setting.University Hospital.Subjects.Participants in the Angina Prognosis Study in Stockholm (APSIS), which comprised 809 patients (248 females) <70 years of age, with chronic stable angina pectoris, of whom 767 (236 females) participated in the present report. Patients with angina pectoris occurring only at rest constituted one group, patients with angina pectoris on effort with or without angina at rest were stratified according to signs of marked ischaemia on exercise and/or clinical signs of heart failure.Methods.Psychosomatic symptoms, job strain, Type‐A behaviour, sleep disturbances and overall life satisfaction were evaluated by a structured interview, which also included questions regarding how the patients usually felt, and health related problems, according to a standardized check‐list.Results.Age correlated with several psychosomatic symptoms and tendency to worry. When adjusted for age and sex, patients with previous myocardial infarction and heart failure described more psychosomatic symptoms, but worried less about the future than patients without these diseases. In the group with angina pectoris at rest only there were fewer smokers than amongst other groups, regardless of risk stratification.Conclusions.Smoking habits and concomitant diseases influence psychosocial variables in patients with stable angina pectoris. The severity of angina pectoris does not seem to relate to life satisfaction and attitudes towards the future.
Activity of cardiopulmonary baroreceptors, peripheral resistance and cutaneous microcirculation in patients with peripheral obstructive arterial disease
Authors: Arosio E. , De Marchi S. , Prior M. , Zannoni M. , Lucchese L. , Lechi A. 
Published: March 2003

Abstract. Arosio E, De Marchi S, Prior M, Zannoni M, Lucchese L, Lechi A (Division of Vascular Medicine and Rehabilitation, University of Verona, Italy). Activity of cardiopulmonary baroreceptors, peripheral resistance and cutaneous microcirculation in patients with peripheral obstructive arterial disease. J Intern Med 2000; 247: 471–478.Objectives. To assess the effects of cardiopulmonary baroreceptors on the haemodynamics of the humeral and common carotid arteries in patients suffering from peripheral artery disease (PAD) and to discover whether the stimulation of these receptors modifies the cutaneous microcirculation in the forearm.Design. We studied a group of patients suffering from peripheral artery disease and two groups as controls.Setting. Patients were examined at the ambulatory for Vascular Research, Division of Vascular Medicine and Rehabilitation, University of Verona.Patients. We studied 15 patients with peripheral artery disease of the lower limbs at Fontaine stage II (group C), 10 free of arterial pathologies (group B) and 10 young people (group A).Main outcome measures. We subjected the patients to passive elevation of the legs and the trunk in a horizontal position with pressure monitoring and measurement of the calibre and flow in the brachial and common carotid arteries using a colourDoppler ultrasound. We also studied the cutaneous microcirculation with laserDoppler flowmetry.Results. During the test, arterial pressure and cardiac frequency remained constant in group A, systolic pressure values showed a slight, but statistically significant increase in group B, whilst the increase in systolic pressure values at this stage was marked in group C. Diastolic pressure values and cardiac frequency remained unchanged in all groups. The calibre of the humeral artery increased in the control groups. Carotid resistance was unchanged in the three groups. Humeral resistance during the test decreased in the two control groups whilst it increased in group C. The number of perfusion units felt in the control groups; no variations in group C.Conclusions. Our study demonstrates, in patients with peripheral artery disease, a reduction in the activity of the cardiopulmonary baroreceptors with an increase in the humeral resistance during the test and impairment of the mechanisms of cutaneous microcirculatory vasoregulation in the forearm.
Myocardial hypertrophy in transgenic mice overexpressing the bovine growth hormone (bGH) gene
Authors: Fu M. L. X. , Törnell J. , Schulze W. , Hoebeke J. , Isaksson O. G. P. , Sandstedt J. , Hjalmarson Å. 
Published: March 2003

Abstract. Fu MLX, Törnell J, Schulze W, Hoebeke J, Isaksson OGP, Sandstedt J, Hjalmarson A (Sahlgrenska University Hospital and University of Göteborg, Göteborg, Sweden; Max‐Delbrück‐Centrum, Berlin, Germany; and IBMC, Strasbourg, France). Myocardial hypertrophy in transgenic mice overexpressing the bovine growth hormone (bGH) gene. J Intern Med 2000; 247: 546–552.Objectives. The main purpose of the present study was to characterize cardiac muscle hypertrophy using both qualitative and quantitative microscopy in mice overexpressing the bovine growth hormone.Results. Measurements of 30 fibres from each group revealed that fibre diameter in transgenic hearts was significantly larger than in control hearts. There was a significant decrease in interfibrillar space in transgenic hearts as compared with control hearts. The enlarged transgenic hearts displayed unchanged organelles such as normal myofibrils and mitochondria in a normal pattern, suggesting balanced growth. Myelin structures were occasionally observed between normal myofibrils. Moreover, myocardial β‐adrenergic receptors and muscarinic receptors in the hearts of transgenic mice overproducing GH were studied to see whether they are involved in the hypertrophic process. It was shown that the density of muscarinic receptors had decreased and the super‐high affinity of muscarinic receptors was lost, without any significant changes in either the density or the affinity of β‐adrenergic receptors, as compared with controls.Conclusions. These results demonstrate that a GH excess was able to induce significant myocardial hypertrophy and that there was a downregulation of muscarinic receptors.
Could attacks of abdominal pain in cases of acute intermittent porphyria be due to intestinal angina?
Authors: Lithner F. 
Published: March 2003

Abstract.   Lithner F (Department of Medicine, University Hospital, Umeå, Sweden). Could attacks of abdominal pain in cases of acute intermittent porphyria be due to intestinal angina? J Intern Med 2000; 247: 407–409.Abdominal pain is by far the most serious symptom in attacks of acute intermittent porphyria. Its cause is unknown. This case study suggests visceral ischaemia as a possible cause of the abdominal pain. A 31‐year‐old woman with recurrent bouts died during an attack; the autopsy revealed a 20‐cm necrotic gangrene in the ileum. A protracted intestinal vasospasm could have been the immediate cause of death. It is discussed whether intestinal angina could be the cause of the abdominal pain in acute intermittent porphyria.