bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social Background and Education of Swedish and Finnish Speakers in Finland
Authors: Saarela Jan , Finnäs Fjalar 
Published: November 2003

AbstractThis article analyses how social background affects completed upper secondary education and completed tertiary level education of Swedish speakers and Finnish speakers in Finland. Longitudinal register data are utilised. The results of logistic regression models indicate that the impact of socio‐economic and family background is strong and declines with education level. For upper secondary education, the impact of social background seems to have decreased over cohorts, which could be attributed to the education reform in the 1970s. The effects of background factors are very similar among Swedish speakers and Finnish speakers. In the Helsinki and Turku areas Swedish speakers have a higher upper secondary education propensity, whereas no such differences between language groups can be found in the other urban, nor in the rural, areas. Swedish speakers are more likely than Finnish speakers to have tertiary level education, which may be attributed to the relatively higher number of student places for Swedish speakers.
Chronic fatigue syndrome: an endocrine disease off limits for endocrinologists?
Authors: Baschetti R. 
Published: November 2003

AbstractEndocrinologists were not included in the multidisciplinary working groups that prepared two recent reports on chronic fatigue syndrome, despite its unequalled clinical overlap with Addison's disease, which is a classic endocrine disorder. The failure to include at least one endocrinologist in those panels may explain why in their extensive reports there is not a single word about the 42 clinical features that chronic fatigue syndrome shares with Addison's disease, including all the signs and symptoms listed in the case definition of this syndrome.
Lipoprotein (a) and acute‐phase response in patients with vestibular neuronitis
Authors: Milionis H. J. , Mittari V. , Exarchakos G. , Kalaitzidis R. , Skevas A. T. , Elisaf M. S. 
Published: November 2003

AbstractBackground  Vestibular neuronitis (VN) is a relatively common condition characterized by the acute onset of vertigo, nausea and vomiting, in the absence of auditory or central nervous system involvement. The exact aetiology (inflammatory, viral or vascular?) remains obscure. Lipoprotein (a) [Lp(a)] is an atherogenic particle. Its serum levels are mainly genetically determined and vary widely between individuals. Whether Lp(a) is consistently a positive acute‐phase reactant is controversial.Purpose  We evaluated the alterations in lipidaemic parameters and serum biological markers (including acute‐phase reactants) in adult patients presenting acutely with VN.Subjects and methods  A total of 34 consecutive VN patients (24 men and 11 women) and 37 apparently healthy controls (25 men and 12 women) were studied. Laboratory evaluation was performed during the acute episode and 6 months later (stable state).Results  Serum Lp(a) concentrations were significantly lower at the time of presentation (median value 6·4 vs. 16·4 mg dL−1 in the stable state, P < 0·001), whereas fibrinogen levels were significantly higher during the acute episode than in the stable state (median value 293·0 vs. 202·0 mg dL−1, respectively, P < 0·0001). During the acute episode, plasma fibrinogen correlated with CRP levels (Spearman r = 0·84, P < 0·0001). By contrast, inverse correlations were noted between Lp(a) levels and CRP (Spearman r = −0·47, P = 0·007) as well as between Lp(a) and fibrinogen levels (Spearman r = −0·35, P = 0·05).Conclusion  Vestibular neuronitis episodes are associated with evidence of an acute inflammatory response as reflected by significant elevations in plasma fibrinogen and CRP concentrations, whereas Lp(a) behaves as a negative acute‐phase reactant.
Genome‐wide screen in obese pedigrees with type 2 diabetes mellitus from a defined Dutch population
Authors: Van Tilburg J. H. , Sandkuijl L. A. , Franke L. , Strengman E. , Pearson P. L. , Van Haeften T. W. , Wijmenga C. 
Published: November 2003

AbstractA genome scan was performed in obese type 2 diabetes mellitus pedigrees to identify susceptibility loci involved in obesity‐driven type 2 diabetes mellitus. We studied the 20% most obese diabetes pedigrees from a confined Dutch population from around the town of Breda. Previously we, and others, have already shown that a susceptibility locus influencing obesity in diabetes may reside on chromosome 18p11. We now report evidence to also suggest linkage for type 2 diabetes in these obese pedigrees on chromosome regions 11p (genome‐wide P‐value ≤ 0·061) and 12q (genome‐wide P‐value ≤ 0·029), thereby confirming previous findings from corresponding regions. The linkage found in the Breda Cohort of type 2 diabetes patients is influenced by obesity. This supports the notion that a genetic predisposition to obesity is probably intertwined with a genetic predisposition to type 2 diabetes. Further efforts should address the question of how, on a genetic level, these two factors interact.
Nasal nitric oxide measurements before and after repeated humming maneuvers
Authors: Maniscalco M. , Sofia M. , Weitzberg E. , Carratu L. , Lundberg J. O. N. 
Published: November 2003

AbstractBackground  It has been recently shown that humming greatly increases nasal nitric oxide (NO). This is most likely owing to a rapid washout of sinus NO caused by the oscillating sound waves. During repeated humming manoeuvres nasal NO gradually decreases, likely because NO accumulated in the sinuses is washed out.Aim  We studied whether humming before measurements would affect nasally exhaled NO.Materials and methods  NO output was measured by the chemiluminescence technique in orally and nasally exhaled air in 38 subjects: 18 healthy subjects (HS), 15 subjects with allergic rhinitis (AR) and five subjects with allergic nasal polyposis (AP). Each subject performed a NO measurement during quiet nasal exhalation either preceded by a period of silence/free speaking or immediately after five consecutive humming manoeuvres (posthumming).Results  Mean nasal NO output (95% CI) after a period of silence/free speaking was 231 nL min−1 (178–284) in HS, 434 nL min−1 (347–522) in AR (P < 0·001) and 262 nL min−1 (163–361) in AP. Post‐humming nasal NO output was 16% (5 to 50%) lower in HS and 14% (1 to 49%) lower in AR, while it remained unchanged in AP subjects. Intra‐subject coefficient of variation of quiet nasal exhalation was 12% in HS, 13% in AR and 5% in AP. Post humming intraindividual coefficient of variation significantly decreased in both HS and AR, but it did not change in AP.Conclusions  Nasal NO levels measured immediately after repeated humming manoeuvres are consistently lower and more reproducible than nasal NO levels measured after a period of silence or free speaking. Repeated humming effectively empties the sinuses, thereby probably minimizing the normal contribution from the sinuses to nasal NO. This may be useful to better estimate NO output from the nasal cavity mucosa in health and disease.
Gender, age and menopause effects on the prevalence and the characteristics of obstructive sleep apnea in obesity
Authors: Resta O. , Caratozzolo G. , Pannacciulli N. , Stefàno A. , Giliberti T. , Carpagnano G. E. , De Pergola G. 
Published: November 2003

AbstractBackground  In the 1970s and 80s it was believed that obstructive sleep apnea (OSA) was primarily a disease of men. The present study was addressed to evaluate the effect of gender and menopause on the prevalence and the characteristics of OSA and on anthropometric, clinical, respiratory and polysomnographic data in a population of obese individuals.Patients and methods  A total of 230 obese subjects (BMI ≥ 30 kg m−2), 148 women and 82 men, aged 16–75 years, were recruited and evaluated for general and anthropometric parameters, respiratory function, sleep‐related symptoms and sleep disorders of breathing.Results  Respiratory disturbance index (RDI) and the prevalence of OSA were lower in women than in men (P < 0·001 and P < 0·001, respectively). Among subjects < 55 years, neck circumference, percentage of predicted normal neck circumference (PPNC), waist‐to‐hip ratio (WHR), PaCO2, RDI and the prevalence of OSA were lower in female subjects (P = 0·05, P < 0·05, P < 0·001, P < 0·01 and P < 0·01, respectively). BMI, neck circumference, PPNC, WHR, RDI and the prevalence of OSA were higher in postmenopausal compared with premenopausal women (P < 0·01, P < 0·01, P < 0·01, P < 0·01 and P < 0·01, respectively).Conclusions  Our study demonstrates that (i) the male dominance regarding the prevalence and the severity of OSA disappears in men older than 55 years, and (ii) menopause seems to play a pivotal role in modulating both the presence and the degree of sleep disorder.
Biocompatibility of resin‐based materials used as pulp‐capping agents
Authors: Costa C. A. S. , Oliveira M. F. , Giro E. M. A. , Hebling J. 
Published: November 2003

AbstractAim  To evaluate and compare the response of pulps of rats capped with resin‐modified glass‐ionomer cement (RMGIC) or self‐etching adhesive system.Methodology  Class I cavities were prepared on the occlusal surface of 54 maxillary first molars of 27 rats. Pulp exposure was performed on the cavity floor. The following resin‐based materials were applied as pulp‐capping agents: G1, Clearfil Liner Bond 2V (CLB 2V; Kuraray Co., Japan); G2, Vitrebond (VIT; 3M/ESPE, USA). In group 3 (control group), a calcium hydroxide/saline paste (CH; Labsynth, Brazil) was used. The cavities were restored with amalgam. After 7, 30 and 60 days, the animals were sacrificed and the jaws were processed for microscopic evaluation.Results  Despite the inflammatory response caused by the experimental and the control materials at 7 days, pulpal healing associated with calcified barrier formation was observed at 60 days following the pulp therapy. Both resin‐based materials promoted a large zone of cell‐rich fibrodentine matrix deposition on the pulp horn related to the pulp exposure site, which was larger to VIT than to CLB 2V specimens. Tertiary dentine underneath the fibrodentine matrix was deposited by a layer of elongated pulpal cells. The remaining pulpal tissue exhibited normal histological characteristics. In the control group, healing and dentine‐bridge formation was observed at 30 days. Pulpal breakdown occurred only when bacterial infection occurred.Conclusion  Both experimental pulp‐capping agents allowed pulpal healing characterized by cell‐rich fibrodentine and tertiary dentine deposition as well as calcified barrier formation.
Focal cemento‐osseous dysplasia involving a mandibular lateral incisor
Authors: Galgano C. , Samson J. , Küffer R. , Lombardi T. 
Published: November 2003

AbstractAim  To report a case of focal cemento‐osseous dysplasia (FCOD) affecting a single tooth misdiagnosed as an inflammatory periapical lesion.Summary  The patient, a black 47‐year‐old woman complained of pain affecting the right side of the mandible. Routine X‐ray examination discovered a periapical radiolucency on the mandibular left lateral incisor (tooth 32), which was otherwise normal and not carious. As the response of this tooth to a vitality test was doubtful, the lesion was diagnosed as a periapical granuloma or cyst secondary to pulpal necrosis. Endodontic treatment and curettage of the periapical lesion were performed, and histological examination of the curettage material revealed a localized osseous dysplasia.Key learning points

FCOD may rarely affect only one tooth, resembling a periapical granuloma or cyst.
Careful diagnosis is of paramount importance in cases of questionable periapical lesions affecting normal‐looking teeth, before beginning treatment.
FCOD generally requires no treatment. Biopsy is warranted in case of doubt.
Comparison of MicroSeal and System B/Obtura II obturation techniques
Authors: Cathro P. R. , Love R. M. 
Published: November 2003

AbstractAim  To compare the proportion of gutta‐percha, sealer and voids following the filling of simulated root canals in plastic blocks using two warm gutta‐percha techniques.Methodology  Ten simulated root canals in plastic blocks were prepared using System GT Rotary Files® and a .02 taper size 40 Quantec rotary nickel–titanium instrument and then filled with MicroSeal and Kerr EWT sealer. A further 10 simulated canals were prepared solely with System GT Rotary Files® and obturated with System B/Obtura II and Kerr EWT sealer. All blocks were sectioned at 1 mm intervals. The sectioned root fillings were photographed through a stereomicroscope and the resultant slides scanned. The images were analysed using adobe photoshop 6.0 to give the proportions of gutta‐percha, sealer or void at each level. The data were analysed using unpaired Student's t‐test and Mann–Whitney U‐test.Results  The MicroSeal technique produced a dense homogeneous gutta‐percha fill at the apical 1 and 2 mm levels similar to the System B/Obtura II technique, but further coronally the sealer became mixed into the MicroFlow gutta‐percha producing a heterogeneous mass with significantly less (P < 0.05) solid gutta‐percha in the root filling compared to System B/Obtura II. The MicroSeal technique generally had more pooling of cement than the System B technique, however, this was only significantly different (P < 0.05) at the 4 mm level. The System B/Obtura II obturation gave an average of 99.27% ± 1.09 gutta‐percha fill at all levels.Conclusions  The MicroSeal technique produced a heterogeneous fill consisting of the MicroFlow Master Cone and gutta‐percha from the MicroFlow Cartridge mixed with sealer. The System B/Obtura II technique produced a homogeneous fill at all levels.
Do anticoagulants improve survival in patients presenting with venous thromboembolism?
Authors: Kelly J. , Hunt B. J. 
Published: November 2003

Abstract.Anticoagulants have been available since around 1940 and have become the standard of treatment for venous thromboembolism (VTE) for over four decades. However, as with other treatments which became established before the evidence‐based era, there is a paucity of evidence from randomized controlled trials validating their effectiveness in preventing the most feared complication of VTE, recurrent fatal pulmonary embolism (PE). Only two such trials have been performed, the results of which conflict. The bulk of data supporting their use are derived from three sources. First, studies of thromboprophylaxis, and comparisons of shorter and longer courses of anticoagulants in high‐risk patients with established VTE have clearly demonstrated their effectiveness in primary and late secondary prevention. Given that heparin has an immediate onset of action, anticoagulants should therefore also be effective in early secondary prevention, the proposed mechanism of action in the acute treatment of VTE. Secondly, studies of inadequately treated patients have consistently shown higher recurrence rates than in those adequately treated. Finally, comparisons of outcomes in untreated and treated historical series, and of untreated historical series to treated series in the modern era have shown substantially lower rates of fatal PE in anticoagulated patients. Because these differences are so marked, harmonize with our current understanding of the mechanism of action of anticoagulants and are supported by other evidence, it is much more likely that they at least partly reflect the effectiveness of anticoagulants as opposed to being explicable purely in terms of accumulated biases and a changing distribution of disease severity.
A young man with a renal colic
Authors: Barbey F. , Matthieu C. , Nseir G. , Burnier M. , Teta D. 
Published: November 2003

Abstract.We report the case of a 35‐year‐old man with no cardiovascular morbidity, presenting with acute flank pain, microscopic haematuria and normal blood pressure. Initially diagnosed as a ureteral colic, the patient was recovered 6 weeks later with severe hypertensive crisis. Further investigations revealed a massive renal infarction secondary to medial fibromuscular dysplasia (FMD). Several aspects of this presentation are intriguing. Renal infarcts are usually seen in older patients having cardiac problems and/or major atheromatous plaques. In addition, FMD is mainly observed in young females and rarely progresses to renal artery occlusion. Furthermore, in this case, FMD remained silent until the acute renal infarction occurred, despite a significant kidney size reduction at the time of diagnosis. Finally, the observation of a delayed hypertensive response to a major renovascular insult provides incentives to discuss possible pathophysiological mechanisms involved in renovascular hypertension.
Use of α‐blockers and the risk of hip/femur fractures
Authors: Souverein P. C. , Van Staa T. P. , Egberts A. C. G. , De la Rosette J. J. M. C. H. , Cooper C. , Leufkens H. G. M. 
Published: November 2003

Abstract.Objective.  To study the association between use of α‐blockers and risk of hip/femur fractures.Design.  Population‐based case–control study.Setting.  General Practice Research Database.Subjects.  Cases were defined as men, aged 40 years and older with a first diagnosis for hip/femur fracture. Controls were matched 1 : 1 on gender, year of birth and general practitioner‐practice.Results.  In all, 4571 cases and an equal number of controls were identified. Current use of α‐blockers (prazosin, doxazosin, indoramin, terazosin, alfuzosin and tamsulosin) was compared with non‐use of α‐blockers. Current use of α‐blockers on the index date was associated with an increased risk of hip/femur fracture [adjusted odds ratio (OR) 1.9, 95% confidence interval (CI): 1.1–3.0] in the overall analysis. The effect was particularly strong for first prescriptions within a treatment episode (adjusted OR 5.1, 95% CI: 1.0–31.7) and during the first month of treatment (adjusted OR 4.1, 95% CI: 0.7–23.9). Stratification according to indication of use showed that current use of α‐blockers was not associated with hip/femur fracture in men with a diagnosis of benign prostatic hyperplasia (adjusted OR 1.0, 95% CI: 0.4–2.5), but was associated in men who used α‐blockers for cardiovascular disease (adjusted OR 2.8, 95% CI: 1.4–5.4).Conclusion.  Current use of α‐blockers was associated with an increased risk of hip/femur fracture and with the start of a new treatment episode. The effect seemed to be confined to patients who used α‐blockers for cardiovascular disease. Caution with respect to first‐dose effects related to the initiation of a new episode of α‐blocker treatment is advised.
Waist circumference, waist–hip ratio and body mass index and their correlation with cardiovascular disease risk factors in Australian adults
Authors: Dalton M. , Cameron A. J. , Zimmet P. Z. , Shaw J. E. , Jolley D. , Dunstan D. W. , Welborn T. A. ,   On behalf of the AusDiab steering committee
Published: November 2003

Abstract.Objectives.  To compare body mass index (BMI), waist circumference and waist–hip ratio (WHR) as indices of obesity and assess the respective associations with type 2 diabetes, hypertension and dyslipidaemia.Design and setting.  A national sample of 11 247 Australians aged ≥25 years was examined in 2000 in a cross‐sectional survey.Main outcome measures.  The examination included a fasting blood sample, standard 2‐h 75‐g oral glucose tolerance test, blood pressure measurements and questionnaires to assess treatment for dyslipidaemia and hypertension. BMI, waist circumference and WHR were measured to assess overweight and obesity.Results.  The prevalence of obesity amongst Australian adults defined by BMI, waist circumference and WHR was 20.8, 30.5 and 15.8% respectively. The unadjusted odds ratio for the fourth vs. first quartile of each obesity measurement showed that WHR had the strongest relationship with type 2 diabetes, dyslipidaemia (women only) and hypertension. Following adjustment for age, however, there was little difference between the three measures of obesity, with the possible exceptions of hypertension in women, where BMI had a stronger association, and dyslipidaemia in women and type 2 diabetes in men, where WHR was marginally superior.Conclusions.  Waist circumference, BMI and WHR identified different proportions of the population, as measured by both prevalence of obesity and cardiovascular disease (CVD) risk factors. Whilst WHR had the strongest correlations with CVD risk factors before adjustment for age, the three obesity measures performed similarly after adjustment for age. Given the difficulty of using age‐adjusted associations in the clinical setting, these results suggest that given appropriate cut‐off points, WHR is the most useful measure of obesity to use to identify individuals with CVD risk factors.
Expression of Th1 markers by lung accumulated T cells in pulmonary sarcoidosis
Authors: Katchar K. , Eklund A. , Grunewald J. 
Published: November 2003

Abstract.Objectives.  The balance between Th1 and Th2 T cells, classified by virtue of their cytokine production can in an immune response influence the phenotype and progression of several clinical diseases. In this study, we examined the expression of Th1 associated chemokine and cytokine receptors CXCR3, CCR5, and interleukin (IL)‐12R, IL‐18R, respectively, as well as of the Th2 associated chemokine receptors CCR4 and CXCR4 on CD4+ and CD8+ T cells.Subjects.  Eighteen patients with untreated pulmonary sarcoidosis.Materials and methods.  We used monoclonal antibodies and flow cytometry to analyse the expression of chemokine receptors CXCR3, CXCR4, CCR4 CCR5 and cytokine receptors IL‐12R, IL‐18R in combination with anti‐CD4 and anti‐CD8 mAbs in bronchoalveolar lavage fluid (BAL) and peripheral blood lymphocytes (PBL) from sarcoidosis patients.Results.  There were significantly more BAL CD4+ T cells expressing CXCR3, CCR5, IL‐12R and IL‐18R compared with paired PBL CD4+ T cells. In contrast, the Th2 associated chemokine receptors CXCR4 and CCR4 were expressed by a fewer percentage of BAL CD4+ compared with PBL CD4+ T cells. There was a positive correlation between the percentage of BAL lymphocytes and the number of CXCR3 and CCR5 expressing CD4+ BAL T cells. Also, the number of CD4+ IL‐18R+ BAL fluid cells correlated negatively with disease duration.Conclusions.  The lung accumulation of CXCR3, CCR5, IL‐12R and IL‐18R expressing T cells is in line with previous reports showing elevated levels in the lung of the corresponding ligands in sarcodosis. Blocking such ligands and/or receptors may develop into a future immunomodulatory therapy.