bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distribution and determinants of ischaemic heart disease in an urban population. A study from the myocardial infarction register in Malmö, Sweden
Authors: Engström G. , Berglund G. , Göransson M. , Hansen O. , Hedblad B. , Merlo J. , Tydén P. , Janzon L. 
Published: March 2003

Abstract.Engström G, Berglund G, Göransson M, Hansen O, Hedblad B, Merlo J, Tydén P, Janzon L (Malmö University Hospital, Malmö, Sweden). Distribution and determinants of ischaemic heart disease in an urban population. A study from the myocardial infarction register in Malmö, Sweden.J Intern Med2000:247; 588–596.Objective.Age adjusted incidence of myocardial infarction has been found to vary substantially between the residential areas of the city of Malmö. The objective of this study was to assess the extent to which major biological risk factors and socio‐economic circumstances account for the differences in incidence of and mortality from myocardial infarction.Design.Ecological study of risk factor prevalence and incidence and mortality from myocardial infarction.Setting.Seventeen administrative areas in Malmö, Sweden.Subjects.Assessment of risk factor prevalence was based on 28 466 men and women, ranging from 45 to 73 years old, who were recruited as participants in the Malmö Diet and Cancer study. Information on serum lipids was available in a random subsample of 5362 subjects. Information about socio‐economic level of the residential area was based on statistics from the Malmö City Council and Statistics Sweden.Main outcome measures.Weighted least square regressions between prevalence of risk factors (i.e. smoking, hypertension, obesity, diabetes, hypercholesterolemia and hypertriglyceridemia), a myocardial infarction risk score, a socio‐economic score and incidence and mortality from myocardial infarction.Results.The risk factor prevalence and myocardial infarction incidence was highest in areas with low socio‐economic level. Prevalence of smoking, obesity and hypertension was significantly associated with myocardial infarction incidence and mortality rates amongst men (allr > 0.60). Prevalence of smoking was significantly associated with incidence and mortality from myocardial infarction amongst women (r = 0.66 andr = 0.61, respectively). A myocardial infarction risk score based on four biological risk factors explained 40–60% of the intra‐urban geographical variation in myocardial infarction incidence and mortality. The socio‐economic score added a further 2–16% to the explained variance.Conclusion.In an urban population with similar access to medical care, well‐known biological cardiovascular risk factors account for a substantial proportion of the intra‐urban geographical variation of incidence of and mortality from myocardial infarction. The socio‐economic circumstances further contribute to the intra‐urban variation in disease.
The association between C‐reactive protein on admission and mortality in patients with acute myocardial infarction
Authors: Nikfardjam M. , Müllner M. , Schreiber W. , Oschatz E. , Exner M. , Domanovits H. , Laggner A. N. , Huber K. 
Published: March 2003

Abstract. Nikfardjam M, Müllner M, Schreiber W, Oschatz E, Exner M, Domanovits H, Laggner AN, Huber K (Vienna General Hospital, University of Vienna, Austria). The association between C‐reactive protein on admission and mortality in patients with acute myocardial infarction. J Intern Med 2000; 247: 341–345.Objective. In patients presenting with acute myocardial infarction the pathophysiologic and prognostic value of serum C‐reactive protein is not well defined. This study assessed the association between serum C‐reactive protein levels on admission and mortality in patients admitted because of acute myocardial infarction.Design. Retrospective cohort study.Setting. Tertiary care centre.Patients. A total of 729 patients with acute myocardial infarction admitted within a period of 3 years.Main outcome measures. C‐reactive protein levels on admission, cardiovascular risk factors and survival within the observational period.Results. Within the 3‐year observational period, 118 patients died of a cardiovascular cause. With increasing serum C‐reactive protein levels (<0.5, 0.5 to <2, 2 to <5, 5–10 and >10 mg dL–1) mortality also increased (14%, 19%, 20%, 39% and 28%, respectively). When controlling for the confounding effect of age, thrombolytic treatment, the time interval between onset of pain and admission, smoking, diabetes mellitus, hypercholesterolemia, hypertension, and elevated creatine kinase on admission in a multivariate Cox regression model, there was only a weak and nonsignificant association between increased serum C‐reactive protein and the risk of death.Conclusions. Patients with elevated concentrations of serum C‐reactive protein admitted to the hospital because of acute myocardial infarction are at an increased risk of dying. This association is however, largely explained by other baseline variables, in particular by an estimate of the duration of myocardial ischaemia. If C‐reactive protein measured by means of an ultra‐sensitive assay is more suitable for risk stratification of unselected patients with acute myocardial infarction, needs further study.
Chronic systemic capillary leak syndrome. Report of a case and review of the literature
Authors: Airaghi L. , Montori D. , Santambrogio L. , Miadonna A. , Tedeschi A. 
Published: March 2003

Abstract. Airaghi L, Montori D, Santambrogio L, Miadonna A, Tedeschi A (IRCCS Ospedale Maggiore Policlinico, Milan, Italy). Chronic systemic capillary leak syndrome. Report of a case and review of the literature (Case Report). J Intern Med 2000; 247: 731–735.Systemic capillary leak syndrome (SCLS) is a rare condition characterized by recurrent episodes of generalized oedema and severe hypotension, associated with paraproteinaemia. In addition to the acute form, a few cases of chronic SCLS have been reported. We describe a 64‐year‐old woman who was hospitalized because of a 6‐month history of progressive generalized oedema with pericardial and pleural effusions, associated with a serum paraprotein. Clinical and laboratory findings were consistent with a chronic form of SCLS. Treatment with prednisone, furosemide and theophylline was started, which led to a gradual improvement in 2 weeks and a persistent remission after 9 months. This report indicates that SCLS may occur in a chronic form, which seems to be responsive to a therapeutic regimen with prednisone, furosemide, and theophylline.
Effectiveness of heparin treatment for progressing ischaemic stroke: before and after study
Authors: Rödén‐Jüllig Å. , Britton M. 
Published: March 2003

Abstract. Rödén‐Jüllig Å, Britton M (Danderyd Hospital, and the Swedish Council on Technology Assessment in Health Care, Stockholm, Sweden). Effectiveness of heparin treatment for progressing ischaemic stroke: before and after study. J Intern Med 2000; 248: 287–291.Objectives. During the acute phase of stroke, symptoms progress in 25% of patients, resulting in a worse outcome. Could heparin treatment improve the situation?Design. Before and after study. During the first period, no treatment was given to patients with progress of symptoms, whereas heparin was used regularly in the second period. A comparison of outcome was performed.Setting. Patients with acute stroke cared for in stroke units of two big emergency hospitals in Stockholm. Besides heparin treatment, the groups were taken care of according to the same basic principles.Subjects. Consecutive patients admitted to a stroke unit during two periods of time. The first study comprised 314 patients with ischaemic stroke and the second 907.Intervention. In the treatment period, patients with ischaemic stroke and objectively recognized progression received heparin infusion for at least 5 days.Main outcome measures. Continued progression, length of stay, unaided walking at discharge, discharge destination and mortality.Results. The progression rate was non‐significantly higher in the first period: 28 vs. 21%. One‐third continued to progress regardless of treatment given. Patients with progression, treated and untreated alike, had 40% longer stay in the stroke unit compared with stable patients, whereas mortality was unaffected. Treatment did not reduce the proportion of patients who needed aid for walking at discharge (77 vs. 74%) or those who needed further institutionalized care (65 vs. 66%).Conclusion. Progression of focal stroke symptoms still constitutes a serious clinical problem for which heparin has insufficient effectiveness in clinical practice. New therapies, ideally preventive, are needed.
Consumption of French‐press coffee raises cholesteryl ester transfer protein activity levels before LDL cholesterol in normolipidaemic subjects
Authors: De Roos B. , Van Tol A. , Urgert R. , Scheek L. M. , Van Gent T. , Buytenhek R. , Princen H. M. G. , Katan M. B. 
Published: March 2003

Abstract. de Roos B, van Tol A, Urgert R, Scheek LM, van Gent T, Buytenhek R, Princen HMG, Katan MB (Wageningen University; Erasmus University, Rotterdam; and Gaubius Laboratory, Leiden; Wageningen Centre for Food Sciences, The Netherlands). Consumption of French‐press coffee raises cholesteryl ester transfer protein activity levels before LDL cholesterol in normolipidaemic subjects. J Intern Med 2000; 248: 211–216.Objectives. To determine the long‐term effects of unfiltered coffee consumption on the activity levels of cholesteryl ester transfer protein (CETP), phospholipid transfer protein (PLTP) and lecithin:cholesterol acyltransferase (LCAT) and to assess a possible role of CETP activity levels in the rise in serum LDL cholesterol.Subjects and design. Forty‐six healthy normolipidaemic subjects consumed 0.9 L of either French‐press or filtered coffee for 24 weeks. Fasting blood samples were obtained after 0, 2, 12 and 24 weeks of intervention and after and 12 weeks of follow‐up.Main outcome measures. Serum activity levels of CETP, PLTP and LCAT.Results. Relative to baseline, French‐press coffee significantly increased average CETP activity by 12% after 2 weeks, by 18% after 12 weeks, and by 9% after 24 weeks. PLTP activity was significantly increased by 10% after 12 and 24 weeks. LCAT activity was significantly decreased by 6% after 12 weeks and by 7% after 24 weeks. The increase in CETP clearly preceded the increase in LDL cholesterol, but not the increase in total triglycerides. However, consumption of French‐press coffee caused a persistent rise in CETP activity, whereas the rise in serum triglycerides was transient.Conclusions. Consumption of cafestol and kahweol cause a long‐term increase in CETP as well as PLTP activity; the increase in CETP activity may contribute to the rise in LDL cholesterol.
Mycobacterium genavense infection in a patient with long‐standing chronic lymphocytic leukaemia
Authors: Krebs T. , Zimmerli S. , Bodmer T. , Lämmle B. 
Published: March 2003

Abstract. Krebs T, Zimmerli S, Bodmer T & Lämmle B (Central Hematology Laboratory, Inselspital, University Hospital of Bern; Institute of Medical Microbiology, University of Bern, Bern, Switzerland). Mycobacterium genavense infection in a patient with long‐standing chronic lymphocytic leukaemia (Case Report). J Intern Med 2000; 248: 343–348.We describe the first case of disseminated infection with Mycobacterium genavense in an HIV‐seronegative patient with a chronic haematological disorder. Our patient, an 80‐year‐old woman, had been under long‐term treatment with chlorambucil (partially in combination with prednisone) for B‐cell chronic lymphocytic leukaemia (B‐CLL). When she developed general fatigue and progressive anaemia, as well as progressive lymphadenopathy and splenomegaly, bone marrow biopsy revealed granulomas with acid‐fast bacilli, and cultures of both bone marrow and blood grew M. genavense. The patient’s CD4+ cell count was approximately 100 µL–1. Treatment with clarithromycin, ethambutol and rifabutin resulted in improvement of anaemia and general health as well as in regression of lymphadenopathy and splenomegaly.
Unintentional weight loss: diagnosis and prognosis. The first prospective follow‐up study from a secondary referral centre
Authors: Lankisch P. G. , Gerzmann M. , Gerzmann J.‐F. , Lehnick D. 
Published: March 2003

Abstract. Lankisch PG, Gerzmann M, Gerzmann J‐F, Lehnick D (Municipal Clinic of Lüneburg, Lüneburg, and University of Göttingen, Göttingen, Germany). Unintentional weight loss: diagnosis and prognosis. The first prospective follow‐up study from a secondary referral centre. J Intern Med 2001; 249: 41–46.Objectives. To establish the incidence and causes of unintentional weight loss and to compare prognoses.Design. Prospective.Setting. Secondary referral centre.Subjects. 158 patients (89 female, 56%; 69 male, 44%) referred by general physicians for unexplained weight loss or for other reasons. In the latter case, weight loss was established after admission to hospital. Follow‐up lasted for up to 3 years.Main outcome measure. Determining the course of weight loss in patients with diagnosed and undiagnosed causes.Results. The cause of weight loss was established in 132 (84%) patients and remained unclear in 26 (16%). Reasons were non‐malignant (60% of patients) and malignant (24%) diseases. Psychological disorders represented 11% of the non‐malignant group. A gastrointestinal disease caused weight loss in 50 (30%) patients. Of malignant disorders, 53% (20 of 38 patients) were gastrointestinal. Amongst the non‐malignant group, 39% (30 of 77 patients) had somatic disorders. The prognosis for unknown causes of weight loss was the same as for non‐malignant causes.Conclusion. Contrary to common belief, weight loss is not usually due to a malignant disease. A gastrointestinal tract disorder accounts for weight loss in every third patient. If minimal diagnostic procedures cannot establish a diagnosis, then endoscopic investigation of the upper and lower gastrointestinal tract and function tests should be performed to exclude malabsorption.
Prediction of diabetes with body mass index, oral glucose tolerance test and islet cell autoantibodies in a regional population
Authors: Rolandsson O. , Hägg E. , Nilsson M. , Hallmans G. , Mincheva‐Nilsson L. , Lernmark Å. 
Published: March 2003

Abstract. Rolandsson O, Hägg E, Nilsson M, Hallmans G, Mincheva‐Nilsson L, Lernmark Å (Umeå University, Sweden; and University of Washington, Seattle, WA, USA). Prediction of diabetes with body mass index, oral glucose tolerance test and islet cell autoantibodies in a regional population. J Intern Med 2001; 249: 279–288. Objective. Our aim was to test the hypothesis that a combination of markers for Type 1 diabetes (glutamate decarboxylase and IA‐2 autoantibodies) and for Type 2 diabetes [oral glucose tolerance test (OGTT) and body mass index (BMI)], would predict clinical diabetes in a regional population. Design. A population‐based follow‐up cohort study. Setting. Participants visited the primary health care centre in Lycksele, Sweden in 1988–92. Participants. A cohort of 2278 subjects (M/F 1149/1129) who were studied at follow‐up in 1998. At base line there were 2314 subjects (M/F 1167/1147) who participated in the Västerbotten Intervention Program on their birthday when turning either 30, 40, 50 or 60 years of age. Main outcome measurements. A clinically diagnosed diabetes at follow‐up when the medical records were reviewed for diagnosis of diabetes. At base line, the participants were subjected to a standard OGTT and their BMI determined along with the autoantibodies. Results. At follow‐up, 42/2278 (1.8%, 95% CI 1.2–2.3) (M/F 23/19) had developed diabetes: 41 subjects were clinically classified with Type 2 and one with Type 1 diabetes. There was no significant relation between autoantibody levels at base line and diabetes at follow‐up. Stepwise multiple logistic regression showed that the odds ratio for developing diabetes was 10.8 (95% CI 6.3–18.9) in subjects in the fourth quartile of BMI (BMI > 27) compared with 7.8 (95% CI 4.8–12.6) in the fourth quartile of 2‐h plasma glucose (>7.5 mmol L−1) and 7.2 (95% CI 4.8–11.4) in the fourth quartile of the fasting plasma glucose (>5.6 mmol L−1). Conclusion. Islet cell autoantibodies did not predict diabetes at follow‐up. BMI measured at base line was as effective as 2‐h plasma glucose and fasting plasma glucose to predict diabetes in this adult population.
Pharmacogenetics: an opportunity for a safer and more efficient pharmacotherapy
Authors: Ingelman‐Sundberg M. 
Published: March 2003

Abstract. Ingelman‐Sundberg M ( IMM, Karolinska Institutet, Stockholm, Sweden). Pharmacogenetics: an opportunity for a safer and more efficient pharmacotherapy. J Intern Med 2001; 250: 186–200.Drug treatment is in many cases ineffective. Besides patients who do not respond to the treatment despite receiving expensive drugs, adverse drug reactions (ADRs) as a consequence of the treatment, is estimated to cost the US society 100 billion USD and over 100 000 deaths per year. Pharmacogenetics is the discipline which takes the patient’s genetic information of drug transporters, drug metabolizing enzymes and drug receptors into account to allow for an individualized drug therapy leading to optimal choice and dose of the drugs in question. It is believed that much cost for the society can be saved in this manner. Many drug transporters are polymorphic. In addition, the majority of phase I and phase II dependent drug metabolism is carried out by polymorphic enzymes which can cause abolished, quantitatively or qualitatively altered or enhanced drug metabolism. Stable duplication, multiduplication or amplification of active genes, most likely in response to dietary components that have resulted in a selection of alleles with multiple noninducible genes, has been described. Several examples exist where subjects carrying certain alleles suffer from a lack of drug efficacy because of ultrarapid metabolism caused by multiple genes or by induction of gene expression, or, alternatively, adverse effects from the drug treatment as a result of the presence of defective alleles. The information about the role of polymorphic drug receptors for efficiency of drug therapy is more scarce, although promising examples are seen in drug treatment of asthma where the efficiency can be severely enhanced by predictive genotyping of the drug targets. In addition, certain polymorphic genes can be used as markers for optimization of the drug therapy. It is likely that predictive genotyping is of benefit in 10–20% of drug treatment and thereby allows for prevention of causalities as a cause of ADRs and thus improves the health for a significant fraction of the patients. In 15–40% of the cases, the penetrance of genetic polymorphism is of less importance because of the polygenic influence on the outcome of drug treatment and in 50% of the cases, pharmacogenetics would be without influence because of other more important physiological and environmental factors. In the present contribution an overview about our present knowledge how polymorphic genes can influence the drug efficacy is presented. Some emphasis will be given to different forms of cytochrome P450 which are of importance for drug metabolism.
Low risk of contrast‐medium‐induced nephropathy with modern angiographic technique
Authors: Sterner G. , Nyman U. , Valdes T. 
Published: March 2003

Abstract. Sterner G, Nyman U, Valdes T (Malmö University Hospital, Malmö, Sweden). Low risk of contrast‐medium‐induced nephropathy with modern angiographic technique. J Intern Med 2001; 250: 429–434. Objective and design. A retrospective study of the incidence of contrast‐medium‐induced nephropathy (CMN) in patients with renal insufficiency. Subjects. All angiographies with and without endovascular therapeutic procedures (n=2400) performed at the hospital during 1 year were evaluated. A total of 139 patients were found to have a preangiographic serum‐creatinine (s‐Cr) of 150 μmol L–1 or above. Postprocedural serial s‐Cr values were present in 118 patients and these were included in the study. Results. Amongst patients receiving only iodinated contrast media (CM) 8% demonstrated a 25% rise in s‐Cr. The corresponding figure was 11 and 12.5% amongst patients who were given either iodinated CM together with carbon dioxide (CO2) or CO2 as sole contrast medium. After exclusion of other explanations of impaired renal function all together only seven of 114 patients (6%) were considered to have developed CMN. Four of the seven patients restituted renal function completely, whilst it remained decreased in three. No patient required dialysis. The percentage of diabetic patients were not found to be different in patients with and without signs of CMN. Conclusions. The present retrospective study indicate that the risk of CMN in connection with angiography is low when modern low‐osmolality CM and contrast saving angiographic technique including CO2 is used combined with proper hydration. Patients with diabetes mellitus were not found more frequently in the groups with CMN.
Sleep complaints predict coronary artery disease mortality in males: a 12‐year follow‐up study of a middle‐aged Swedish population
Authors: Mallon L. , Broman J.‐E. , Hetta J. 
Published: March 2003

Abstract. Mallon L, Broman J‐E, Hetta J (University Hospital, Uppsala, and Falun Hospital, Falun; and Institute of Clinical Neuroscience, Göteborg; Sweden). Sleep complaints predict coronary artery disease mortality in males: a 12‐year follow‐up study of a middle‐aged Swedish population. J Intern Med 2002; 251: 207–216. Objectives. Only a few prospective surveys have been performed to investigate the relationship between sleep complaints and coronary artery disease (CAD) mortality. This study was conducted to determine whether sleep complaints in a middle‐aged population predicted total mortality and CAD mortality. Design. A population‐based prospective study. Setting. The County of Dalarna, Sweden. Subjects and methods. In 1983, a random sample of 1870 subjects aged 45–65 years responded to a postal questionnaire (response rate 70.2%) including questions about sleep complaints and various diseases. Mortality data for the period 1983–95 were collected, and Cox proportional hazard analyses were used to examine the mortality risks. Results. At 12‐year follow‐up 165 males (18.2%) and 101 females (10.5%) had died. After adjustment for a wide range of important putative risk factors, difficulties initiating sleep (DIS) were related to CAD death in males [relative risk (RR), 3.1; 95% confidence interval (CI), 1.5–6.3; P < 0.01], but not in females. Short or long sleep duration did not influence risk of CAD mortality or total mortality for either gender. Depression in males increased the risk of death attributed to CAD (RR, 3.0; 95% CI, 1.1–8.4; P < 0.05) and total mortality (RR, 2.2; 95% CI, 1.1–4.5; P < 0.05). Conclusion. These results provide evidence that there is an association between difficulties falling asleep and CAD mortality in males.