bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parasympathetic function during deep breathing in the general population: relation to coronary risk factors and normal range
Authors: May O. , Arildsen H. , Møller M. 
Published: March 2003

Abstract. May O, Arildsen H, Møller M (Odense University Hospital, Odense and Horsens Hospital, Horsens, Denmark). Parasympathetic function during deep breathing in the general population: relation to coronary risk factors and normal range. J Intern Med 1999; 245: 287–94.Objectives. To examine the association between the parasympathetic function assessed by deep breathing‐induced heart rate variability (HRV) and coronary risk factors and to establish a reference range for deep breathing‐induced HRV.Design. Cross‐sectional population‐based study.Setting. The municipality of Horsens, Denmark.Subjects. One hundred and ninety‐four individuals aged 40–67 years without diabetes, atrial fibrillation or a pacemaker randomly selected from the population.Main outcome measures. During deep breathing at 6 respiratory cycles min−1, an ECG was taken and in three consecutive cycles the longest R–R interval during expiration (E) and the shortest during inspiration (I) were selected. The mean ratio (E/Iratio) and the mean difference in instantaneous heart rate (E/Idiff) were taken as expressions of the parasympathetic function.Results. In multivariate analysis, E/Idiff was reduced with increasing age (P < 0.0005) and left ventricular mass (P = 0.008), with ECG sign of probable previous myocardial infarction (P = 0.020) and the use of cardiac medication (P = 0.018) and positively correlated to heart rate (P = 0.030). The E/Iratio was diminished with increasing age (P = 0.001), left ventricular mass (P = 0.003), waist–hip ratio (P = 0.044), with ECG sign of probable previous myocardial infarction (P = 0.012) and use of cardiac medication (P = 0.020), but no association was found with heart rate (P = 0.92). In both E/Idiff and E/Iratio, no correlation was found to lipids, blood pressure or alcohol consumption. In the group not on cardiac medication, without left ventricular hypertrophy or ECG sign of probable myocardial infarction, E/Idiff and E/Iratio were still independently correlated to age and left ventricular mass. In this group, equations defining the age‐corrected 5th percentile were calculated.Conclusions. The parasympathetic function as assessed by deep breathing‐induced HRV in the general population is reduced in older people, and in individuals on cardiac medication, with left ventricular hypertrophy or ECG signs of myocardial infarction. Even in healthy persons the parasympathetic function is inversely associated with age and left ventricular mass. Values of E/Idiff above (4.39–0.033 × age)2 and readings of E/Iratio above 1 + exp (− 1.12–0.0198 × age) can be regarded as normal.
A patient with neurofibromatosis type 1 and watery diarrhoea syndrome due to a VIP‐producing adrenal phaeochromocytoma
Authors: Quarles Van Ufford‐Mannesse P. , Castro Cabezas M. , Vroom T. M. , Van Gils A. P. G. , Lips C. J. M. , Niermeijer P. 
Published: March 2003

Quarles van Ufford‐Mannesse P, Castro Cabezas M, Vroom TM, van Gils APG, Lips CJM, Niermeijer P (University Hospital Utrecht, Utrecht, and Gooi‐Noord Hospital Blaricum, the Netherlands). A patient with neurofibromatosis type 1 and watery diarrhoea syndrome due to a VIP‐producing adrenal phaeochromocytoma (Case Report). J Intern Med 1999; 246: 231–234.A 43‐year‐old patient with neurofibromatosis type 1 suffered from watery diarrhoea syndrome induced by excessive production of vasoactive intestinal polypeptide (VIP) in an adrenal phaeochromocytoma. This case report emphasizes that patients with neurofibromatosis are prone to develop more than one disease induced by tumours originating from the neural crest. Since excessive VIP production in a phaeochromocytoma may mask the symptoms of catecholamine overproduction, and in view of the therapeutic consequences, neurofibromatosis patients with hyperVIP‐aemia must be checked for the presence of a phaeochromocytoma.
Plasma lipoprotein particle concentrations in postmenopausal women with unstable coronary artery disease. Analysis of diagnostic accuracy using receiver operating characteristics
Authors: Nielsen N. E. , Olsson A. G. , Swahn E. 
Published: March 2003

Abstract. Nielsen NE, Olsson AG, Swahn E (University Hospital, Linköping, Sweden). Plasma lipoprotein particle concentrations in postmenopausal women with unstable coronary artery disease. Analysis of diagnostic accuracy using receiver operating characteristics. J Intern Med 2000; 247: 43–52.Background. The contribution of plasma lipids to cardiovascular risk is usually evaluated by measuring plasma concentrations of total cholesterol, triglycerides and HDL cholesterol, and calculating LDL cholesterol concentration. We investigated plasma concentrations of apolipoproteins and lipoprotein particles in women with unstable coronary artery disease (CAD) to evaluate whether these, better than the routine lipid status, could differentiate women with and without coronary atherosclerosis.Methods. Blood samples for lipid analyses were collected from 119 angiographically examined postmenopausal 49–79‐year‐old women with unstable CAD, and from 101 age‐matched controls. Mean plasma concentrations were compared and the discriminatory ability of the different variables were tested using receiver operating characteristics (ROC).Results. At coronary angiography 19% had normal vessels and 81% had coronary atherosclerosis. A disturbed triglyceride metabolism was the most pronounced lipid abnormality in women with unstable CAD and coronary atherosclerosis. ROC showed that none of the evaluated variables had a particularly high discriminatory power regarding unstable CAD or coronary atherosclerosis. The ratio cholesterol/HDL cholesterol was best with an ROC area of 0.79. Furthermore, the newer lipid variables, i.e. lipoprotein particles and apolipoproteins, were no better than the traditional variables.Conclusion. Lipoprotein changes reflecting a disturbed triglyceride metabolism are most pronounced in women with unstable CAD and coronary atherosclerosis. Lipoprotein particles and apolipoproteins alone were no better than lipids and lipoproteins in separating women with from those without coronary atherosclerosis. Our study does not support the measurement of apolipoproteins and lipoprotein particles on the basis of diagnostic accuracy alone.
Secular changes in cardiovascular risk factors over 30 years in Swedish men aged 50: the study of men born in 1913, 1923, 1933 and 1943
Authors: Rosengren A. , Eriksson H. , Larsson B. , Svärdsudd K. , Tibblin G. , Welin L. , Wilhelmsen L. 
Published: March 2003

Abstract. Rosengren A, Eriksson H, Larsson B, Svärdsudd K, Tibblin G, Welin L, Wilhelmsen L (Sahlgrenska University Hospital/östra, Göteborg and Uppsala University, Uppsala, Sweden). Secular changes in cardiovascular risk factors over 30 years in Swedish men aged 50: The Study of Men Born in 1913, 1923, 1933 and 1943. J Intern Med 2000; 247: 111–118.Objectives. To study secular trends in cardiovascular risk factors in men aged 50 over a period of 30 years.Design. Cross‐sectional studies of successive cohorts of men from 1963 to 1993.Setting. City of Göteborg, Sweden.Subjects. Four random population samples of men born in 1913, 1923, 1933 and 1943, aged 50 when they were examined in 1963, 1973, 1983, and 1993 (n = 855, 226, 776, and 798, respectively).Main outcome measures. Anthropometric measurements, blood pressure, serum cholesterol and triglycerides and smoking habits over three decades.Results. Over 30 years, men increased in weight from a mean (SD) of 75.9 (11.0) kg to 82.8 (12.1) kg and gained 3.4 cm in height, with a net increase in body mass index from 24.8 (3.2) to 26.0 (3.4) kg m–2 (P < 0.0001), and a concomitant increase in waist circumference. The proportion of men who were overweight but not obese (BMI = 25–30 kg m–2) increased from 38 to 47%, whereas the prevalence of frank obesity (more than 30 kg m–2) increased from 6% in 1963 to 11% in 1993. Despite the increase in weight, mean systolic blood pressure fell by almost 10 mmHg (P < 0.0001). Mean serum cholesterol concentration decreased from 6.42 (1.12) to 5.88 (1.04) (P < 0.0001). Serum triglycerides increased from 1.26 (0.77) to 1.69 (1.04) mmol L–1 (P = 0.001). The proportion of men who smoked decreased from 56% in 1963 to 30% in 1993 (P < 0.0001). This was due more to an increase in smoking cessation rates than to an increase in the proportion of men who had never smoked. In particular, smokers and former smokers are now more obese than the corresponding categories 30 years ago and smokers are no longer leaner than men who have never smoked.Conclusions. Over a period of 30 years, serum cholesterol as well as systolic blood pressure and the prevalence of smoking decreased. This favourable decline in coronary risk factors was offset by an appreciable increase in body mass index and waist circumference.
Calcaneal ultrasound measurements are determined by age and physical activity. Studies in two Swedish random population samples
Authors: Landin‐Wilhelmsen K. , Johansson S. , Rosengren A. , Dotevall A. , Lappas G. , Bengtsson B.‐Å. , Wilhelmsen L. 
Published: March 2003

Abstract. Landin‐Wilhelmsen K, Johansson S, Rosengren A, Dotevall A, Lappas G, Bengtsson B‐A, Wilhelmsen L (Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden). Calcaneal ultrasound measurements are determined by age and physical activity. Studies in two Swedish random population samples. J Intern Med 2000; 247: 269–278.Aim. To present reference values and correlations with body composition, blood variables and lifestyle factors.Subjects. Two random population samples from Göteborg, Sweden, one comprising 184 men and 455 women aged 25–64 years (MONICA) and the other 860 women aged 55–82 years (BEDA) were studied.Methods. Calcaneal ultrasound measurement (LUNAR Achilles) and bioimpedance were measured. Smoking habits, coffee consumption, physical activity, psychological stress, education and marital status, as well as blood lipids, blood pressure, and fractures were studied.Results. Broadband ultrasound attenuation and stiffness were higher in men than in women (P < 0.001), but speed of sound did not differ between sexes. Speed of sound, broadband ultrasound attenuation and stiffness decreased with age (P < 0.001).In both sexes speed of sound, broadband ultrasound attenuation and stiffness correlated positively to body size variables, and negatively with smoking in women after adjustment for age. Speed of sound, broadband ultrasound attenuation and stiffness were positively related to physical activity in both sexes, and these relationships were the only ones that remained in multivariate analyses in addition to age (negative).Osteoporotic fractures increased with age. Speed of sound, broadband ultrasound attenuation and stiffness were lower amongst women with osteoporotic fractures.Conclusion. Speed of sound, broadband ultrasound attenuation and stiffness decreased with age and increased with physical activity, but body weight and height were not correlated in multivariate analyses. Osteoporotic fractures increased with age and were associated with lower calcaneal ultrasound values.
Genetic background of Lewis negative blood group phenotype and its association with atherosclerotic disease in the NHLBI Family Heart Study
Authors: Salomaa V. , Pankow J. , Heiss G. , Cakir B. , Eckfeldt J. H. , Ellison R. C. , Myers R. H. , Hiller K. M. , Brantley K. R. , Morris T. L. , Weston B. W. 
Published: March 2003

Abstract. Salomaa V, Pankow J, Heiss G, Cakir B, Eckfeldt JH, Ellison RC, Myers RH, Hiller KM, Brantley KR, Morris TL, Weston BW (National Public Health Institute, Helsinki, Finland, University of North Carolina, University of Minnesota, Boston University School of Medicine, USA). Genetic background of Lewis negative blood group phenotype and its association with atherosclerotic disease in the NHLBI Family Heart Study, J Intern Med 2000; 247: 689–698.Objectives. To examine the prevalence of four mutations, T59G, T1067A, T202C and C314T, of the human α(1,3/1,4) fucosyltransferase 3 (FUT 3) gene amongst persons with Lewis negative and those with Lewis positive blood group phenotype. An additional objective was to explore the hypothesis that these mutations are associated with coronary heart disease and inflammatory reaction.Design. A population‐based cross‐sectional study.Setting. Analysis of samples and data from the National Heart Lung and Blood Institute Family Heart Study.Subjects. All Lewis (a–b–) participants (n = 136) and a sample of Lewis positive participants (n = 136) of the Family Heart Study; all were of Caucasian ethnicity.Main outcome measures. The prevalence of examined mutations by Lewis phenotype.Results. The examined mutations were common and strongly associated with the Lewis (a–b–) phenotype. Accordingly, 90–95% of Lewis (a–b–) individuals amongst Caucasians can be identified by screening for these four mutations. Exploratory analyses suggested that with the exception of T59G, all examined mutations were positively associated with prevalent coronary heart disease, although not statistically significantly, perhaps due to the small number of prevalent coronary heart disease cases. C‐reactive protein tended to be higher amongst persons with a TC or CC genotype at position 202 (3.07 ± 0.41 vs. 2.08 ± 0.32 mg L–1, P = 0.06).Conclusions. Four specific mutations of fucosyltransferase 3 gene are responsible for the vast majority of Lewis (a–b–) phenotypes in Caucasians. These mutations are common in the population at large and may be associated with increased risk of coronary heart disease. Further studies using larger samples are warranted.
Quality of life of chronic stable angina patients 4 years after coronary angioplasty or coronary artery bypass surgery
Authors: Brorsson B. , Bernstein S. J. , Brook R. H. , Werkö L. 
Published: March 2003

Abstract. Brorsson B, Bernstein SJ, Brook RH, Werkö L (The Swedish Council on Technology Assessment in Health Care, Stockholm, Sweden; Norrland University Hospital, Umeå, Sweden; Veterans Affairs Health Services Research and Development Field Program, Ann Arbor, MI, USA; University of Michigan, Ann Arbor, MI, USA; Instituto de Salud Carlos III, Madrid, Spain; University of California, Los Angeles; and RAND Corporation, Santa Monica, CA, USA). Quality of life of chronic stable angina patients 4 years after coronary angioplasty or coronary artery bypass surgery. J Intern Med 2001; 249: 47–57.Objective. To evaluate the quality of life experienced by chronic stable angina patients with one‐ or two‐vessel coronary artery disease treated with percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass graft (CABG).Design. Prospective survey and review of medical records.Patients. Consecutive series of 601 Swedish chronic stable angina patients with one‐ or two‐vessel disease who underwent CABG (n = 252) or PTCA (n = 349) between May 1994 and January 1995.Main outcome measures. We assessed five components of the Swedish Quality of Life Survey, anginal frequency, sublingual nitroglycerin use, and survival at 6, 21 and 48 months following coronary revascularization.Results. Anginal frequency and sublingual nitroglycerin use decreased for all patients by 6 months, but more amongst surgery patients than amongst angioplasty patients (P < 0.05). At 48 months, more bypass patients reported that they had not used sublingual nitroglycerin during the preceding 4 weeks (73.1 vs. 63.4%, P < 0.05). At 6 months, bypass patients had greater levels of improvement in physical functioning (15.3 vs. 10.5, P < 0.05) and general health perception (16.5 vs. 10.2, P < 0.05) than angioplasty patients. Bypass patients also had better relief from pain (19.4 vs. 14.6, P < 0.05), quality of sleep (17.6 vs. 4.6, P < 0.05) and general health perception (17.3 vs. 12.1, P < 0.05) at 21 months. By 48 months follow‐up, there was no longer any difference in these measures between groups.Conclusions. Both bypass surgery and angioplasty lead to improved quality of life for patients with chronic stable angina and one‐ or two‐vessel coronary artery disease. Bypass surgery is associated with better quality of life at 6 months, but by 48 months quality of life is similar for patients initially treated by either procedure.
Insulin resistance adds to endothelial dysfunction in hypertensive patients and in normotensive offspring of subjects with essential hypertension
Authors: Žižek B. , Poredoš P. 
Published: March 2003

Abstract. Žižek B, Poredoš P (University Medical Centre, Ljubljana, Slovenia). Insulin resistance adds to endothelial dysfunction in hypertensive patients and in normotensive offspring of subjects with essential hypertension. J Intern Med 2001; 249: 189–197. Objectives. To evaluate whether endothelium‐dependent (nitric oxide‐mediated) dilation of the brachial artery (BA) is impaired in patients being treated for essential hypertension (EH), and whether this abnormality can be detected in normotensive offspring of subjects with EH (familial trait, FT); and to investigate the interrelationship between flow‐mediated vasodilation (FMD) and hyperinsulinaemia/insulin resistance. Design. Cross‐sectional study. Setting. Angiology department at a teaching hospital. Subjects. The study encompassed 172 subjects, of whom 46 were treated hypertonics aged 40–55 (49) years, and 44 age‐matched, normotensive volunteers as controls. We also investigated 41 normotonics with FT aged 20–30 (25) years and 41 age‐and sex‐matched controls without FT. Main outcome measures. Using high‐resolution ultrasound, BA diameters at rest, during reactive hyperaemia (endothelium‐dependent dilation) and after sublingual glyceryl trinitrate (GTN) application (endothelium‐independent dilation) were measured. Results. In hypertonics FMD was significantly lower than in controls [2.4 (2.9) vs. 7.4 (2.5)%; P < 0.00005], as was GTN‐induced dilation [12.1 (4.3) vs. 16.1 (4.6)%; P=0.0007]. In subjects with FT, FMD was also decreased compared with the control group [5.8 (4.1) vs. 10.0 (3.0)%; P < 0.00005]. The response to GTN was comparable in both groups of young subjects. FMD was negatively related to insulin concentration in all subjects studied (P < 0.00005). Conclusions. In treated patients with EH, flow‐mediated dilation of the BA as well as endothelium‐independent dilation are decreased. In individuals with FT the endothelial function of the peripheral arteries is also altered in the absence of elevated blood pressure. Endothelial dysfunction is related to hyperinsulinaemia/insulin resistance, which could be one of the pathogenetic determinants of EH and its complications.
Gene therapy for genetic haematological disorders and immunodeficiencies
Authors: Kohn D. B. 
Published: March 2003

Abstract. Kohn DB (Children’s Hospital and Keck School of Medicine, Los Angeles, CA, USA). Gene therapy for genetic haematological disorders and immunodeficiencies. J Intern Med 2001; 249: 379–390.Gene transfer and autologous transplantation of haematopoietic stem cells (HSCs) from patients with genetic haematological disorders and immunodeficiencies could provide the same benefits as allogeneic HSC transplantation, without the attendant immunological complications. Inefficient gene delivery to human HSCs has imposed the major limitation to successful application of gene therapy. A recently reported clinical trial of gene transfer into HSCs of infants with X‐linked severe combined immunodeficiency (SCID) has achieved immune restoration because of the selective outgrowth of the gene‐corrected lymphocytes. Newer methods for manipulating HSCs may lead to efficacy for other disorders. The problems and progress in this area are reviewed herein.
Increased levels of tPA antigen and tPA/PAI‐1 complex in myotonic dystrophy
Authors: Johansson Å. , Boman K. , Cederquist K. , Forsberg H. , Olsson T. 
Published: March 2003

Abstract. Johansson Å, Boman K, Cederquist K, Forsberg H, Olsson T (Umeå University Hospital, Umeå, Skellefteå County Hospital, Skellefteå, and Boden Hospital, Boden, Sweden). Increased levels of tPA antigen and tPA/PAI‐1 complex in myotonic dystrophy. J Intern Med 2001; 249: 503–510. Objective. To assess the fibrinolytic system in myotonic dystrophy (DM1), a disease connected to features of the metabolic syndrome, including a prominent insulin resistance, increased body fat mass, and hypertriglyceridaemia. We hypothesized that abnormalities in the fibrinolytic system are linked to metabolic dysfunction in DM1. Design. Circulating morning levels of tissue plasminogen activator (tPA) and plasminogen activator inhibitor type 1 (PAI‐1) antigens, tPA/PAI‐1 complex, lipids and insulin were determined. Genetic analyses, including calculation of allele size, were performed in all patients. Body fat mass was estimated with bioelectrical impedance analysis. Setting. Out‐patient clinic in collaboration with Umeå University Hospital. Subjects. A total of 42 otherwise healthy patients with DM1 (22 men, 20 women; median age 41.5 years) and 50 controls (27 men, 23 women; median age 42.0 years). Main outcome measures. The tPA and PAI‐1 antigens, tPA/PAI‐1 complex, blood lipids and body fat mass. Results. The tPA antigen and tPA/PAI‐1 complex levels were significantly increased in DM1 patients (P < 0.001 and P < 0.05, respectively) whilst levels of PAI‐1 did not differ from controls. Triglyceride levels were increased (P < 0.001) whereas HDL cholesterol levels were lower in DM1 patients (P < 0.05). Body fat mass was increased in DM1 patients (P < 0.001). Conclusions. The fibrinolytic system is disturbed in DM1 patients, with increased levels of tPA and tPA/PAI‐1 complex but paradoxically unaltered levels of PAI‐1, in spite of a severely increased body fat mass. This may imply an abnormal function of adipose tissue in DM1, and calls for further studies of the fibrinolytic system in this disease.
Heart rate variability and n‐3 polyunsaturated fatty acids in patients with diabetes mellitus
Authors: Christensen J. Hagtrup , Skou H. Aarup , Madsen T. , Tørring I. , Schmidt E. Berg 
Published: March 2003

Abstract. Hagstrup Christensen J, Aarup Skou H, Madsen T, Tørring I, Berg Schmidt E (Aalborg Hospital, Aalborg; and Hjørring/Brønderslev Hospital, Hjørring, Denmark). Heart rate variability and n‐3 polyunsaturated fatty acids in patients with diabetes mellitus. J Intern Med 2001; 249: 545–552. Objectives. Dietary n‐3 polyunsaturated fatty acids (PUFA) derived from fish may reduce the incidence of sudden cardiac death (SCD). The aim of the present study was to examine associations between n‐3 PUFA and 24‐h heart rate variability in patients with type 1 and type 2 diabetes mellitus (DM). Design. Observational study. Setting. The out‐patient’s diabetic clinic at Hjørring Hospital, Hjørring, Denmark. Subjects. Forty‐three patients with type 1 DM and 38 patients with type 2 DM. Main outcome measures. The patients fulfilled a food‐questionnaire regarding fish consumption, whilst the content of n‐3 PUFA in platelets was measured and 24‐h heart rate variability (HRV) was obtained. Results. The patients fish consumption was strongly related to their content of n‐3 PUFA in platelets. Furthermore, in patients with type 1 DM a close positive association was found between the content of n‐3 PUFA in platelets and 24‐h HRV. This association was not significant in patients with type 2 DM. Conclusions. The positive association between n‐3 PUFA in platelets and HRV may indicate a beneficial effect of n‐3 PUFA on HRV in patients with type 1 DM. Further studies are warranted to clarify whether supplementation with n‐3 PUFA reduce the risk of SCD amongst patients with DM.