bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute lung injury due to parvovirus pneumonia
Authors: Wardeh  , Marik  
Published: March 2003

Wardeh A, Marik P, (Department of Critical Care, St. Vincent Hospital, Massachusetts, USA and the University of Massachusetts and Medical Intensive Care Unit St. Vincent Hospital, Massachusetts, USA). Acute lung injury due to parvovirus pneumonia (Case Report). J Intern Med 1998; 244: 257–60.ObjectiveHuman parvovirus B19 is responsible for the common childhood exanthematous illness, erythema infectiosum. Adults infected with B19 have been reported to develop a febrile illness associated with arthritis. Life threatening parvovirus infections in non‐immunocompromised adults have not been reported to date. We report a previously healthy middle aged female who developed severe parvovirus pneumonia. The patient recovered with supportive care provided in the ICU. Parvovirus may represent an under diagnosed cause of community acquired pneumonia.
The lymphocytic alveolitis in sarcoidosis is associated with increased amounts of soluble and cell‐bound adhesion molecules in bronchoalveolar lavage fluid and serum
Authors: Berlin M. , Lundahl J. , Sköld C. M. , Grunewald J. , Eklund A. 
Published: March 2003

Berlin M, Lundahl J, Sköld CM, Grunewald J, Eklund A (Karolinska Hospital and Karolinska Institute, Stockholm, Sweden). The lymphocytic alveolitis in sarcoidosis is associated with increased amounts of soluble and cell‐bound adhesion molecules in bronchoalveolar lavage fluid and serum. J Intern Med 1998; 244: 333–340.ObjectivesPulmonary sarcoidosis is a chronic inflammatory disorder of unknown aetiology accompanied by a lymphocytic alveolitis. It is likely that a selective and temporal expression of adhesion molecules plays a crucial role in the recruitment of cells to the inflammatory site. We investigated the expression of adhesion molecules on alveolar T‐lymphocytes and in bronchoalveolar lavage (BAL) fluid and serum to elucidate mechanisms behind the accumulation of cells in the lung in sarcoidosis.DesignIn a cross‐sectional study in patients with active and inactive sarcoidosis and in healthy volunteers, we examined, in serum and in BAL fluid, the soluble adhesion molecules, VCAM‐1, ICAM‐1, and P‐, E‐ and L‐selectin. In addition, the expressions of α4‐β1 (VLA‐4) and α5‐β1 (VLA‐5) integrins on alveolar T‐lymphocytes were analysed.SettingThe subjects attended the outpatient clinic at the Division of Respiratory Medicine, Karolinska Hospital, Stockholm, Sweden.SubjectsNineteen sarcoidosis patients, nine with clinically active disease, and 13 healthy volunteers were included in the study. The sarcoidosis diagnosis was based on a typical histological and/or clinical (symptoms, radiograph, lung function) picture.ResultsIn sarcoidosis patients, particularly in those with active disease, an increase of the expressions of β1‐integrins was accompanied by elevated concentrations in BAL fluid of soluble VCAM‐1. In serum, the levels of E‐selectin and ICAM‐1 were significantly higher in patients with active disease than in those with inactive disease and controls.ConclusionsThe findings offer some mechanistic explanations as to how the cell‐rich alveolitis in sarcoidosis occurs, and furthermore suggest additional markers, such as s‐ICAM‐1, for assessment of disease activity.
Poikilothermia syndrome
Authors: Kurz  , Kurz  , Sessler  , Sessler  , Sessler  , Sessler  , Tayefeh  , Goldberger  
Published: March 2003

Abstract. Kurz A, Sessler DI, Tayefeh F, Goldberger R (Outcomes Research Group; University of Vienna, Austria; University of California, San Francisco, USA; Ludwig Boltzmann Institute for Clinical Anaesthesia and Intensive Care, Vienna, Austria; and Columbia University College of Physicians and Surgeons, New York, USA). Poikilothermia syndrome (Case Report). J Intern Med 1998; 244: 431–6.Poikilothermia syndrome is a rare cause of intrinsic thermoregulatory failure. Patients with this syndrome regulate body temperature poorly, if at all. Recently, a patient was referred to us who had clinical evidence of poikilothermia syndrome, as well as long‐standing multiple sclerosis. Computerized tomography and magnetic resonance scanning failed to identify a hypothalamic lesion. The patient was gradually warmed to sweating, and then cooled to vasoconstriction and shivering. The core‐temperature thresholds triggering each defence were calculated, after compensating for the changes in skin temperature. The calculated sweating threshold was 38.3 °C (normal: 37.0 ± 0.3 °C). The vasoconstriction threshold was 34.4 °C (normal: 36.4 ± 0.3 °C). The sweating‐to‐vasoconstriction interthreshold range was thus ≊4 °C, which is between 10 and 20 times the normal value. The shivering threshold was 31.8 °C (normal: 35.6 ± 0.3 °C). The vasoconstriction‐to‐shivering range was thus ≊2.5 °C which is more than twice the normal value. The pattern of thermoregulatory failure in this patient resembled that resulting from general anaesthesia.
Decreased heart rate variability in patients with type 1 diabetes mellitus is related to arterial wall stiffness
Authors: Jensen‐Urstad K. , Reichard P. , Jensen‐Urstad M. 
Published: March 2003

Abstract.Objective. Low heart rate variability (HRV) is, in several patient groups, related to poor prognosis. The underlying mechanisms are still unclear. The aim was to study if there is a relationship between HRV, which is a measure of baroreceptor function, and atherosclerosis.Design. The relationship between heart rate variability and carotid arterial wall stiffness was studied in subjects with type 1 diabetes mellitus in which autonomic dysfunction and early atherosclerosis are common. HRV was assessed from power spectral analysis of 24‐h Holter recordings and arterial wall stiffness was assessed from an ultrasound study of the right common carotid artery.Setting. A university hospital.Subjects. Fifty‐nine patients (41 ± 8 years) from the Stockholm Diabetes Intervention Study (SDIS) were investigated. These patients were randomized to intensified conventional treatment or standard treatment approximately 12 years before this study.Results. Patients with stiffer arteries had lower HRV in all spectral bands (r=−0.32 to −0.40, P= 0.06–0.001). This relation remained on correcting for age. All spectral parameters of HRV correlated with the mean HbA1c from 10 years of study (r=−0.37 to −0.40, P= 0.004–0.001).Conclusions. In patients with type 1 diabetes mellitus, heart rate variability and arterial wall stiffness are related to each other. The results suggests that the autonomic nervous system could be a link between diabetes and vascular disease.
A comparison of metoprolol and morphine in the treatment of chest pain in patients with suspected acute myocardial infarction – the MEMO study
Authors: Everts B. , Karlson B. , Abdon N.‐J. , Herlitz J. , Hedner T. 
Published: March 2003

Objectives. To compare the analgesic effect of metoprolol and morphine in patients with chest pain due to suspected or definite acute myocardial infarction after initial treatment with intravenous metoprolol.Design. All patients, regardless of age, admitted to the coronary care unit at Uddevalla Central Hospital due to suspected acute myocardial infarction were evaluated for inclusion in the MEMO study (metoprolol–morphine). The effects on chest pain and side‐effects of the two treatments were followed during 24 h. Pain was assessed by a numerical rating scale.Results. A total of 265 patients were randomized in this prospective double‐blind study and 59% developed a confirmed acute myocardial infarction. In both treatment groups, there were rapid reductions of pain intensity. However, in the patient group treated with morphine, there was a more pronounced pain relief during the first 80 min after start of double‐blind treatment. The side‐effects were few and were those expected from each therapeutic regimen. During the first 24 h, nausea requiring anti‐emetics was more common in the morphine‐treated patients.Conclusion. In suspected acute myocardial infarction, if chest pain persists after intravenous beta‐adrenergic blockade treatment, standard doses of an opioid analgesic such as morphine will offer better pain relief than increased dosages of metoprolol.
Comparison of secondary prevention measures after myocardial infarction in subjects with and without diabetes mellitus
Authors: Chowdhury T. A. , Lasker S. S. , Dyer P. H. 
Published: March 2003

Abstract. Chowdhury TA, Lasker SS, Dyer PH (Birmingham Heartlands Hospital, Birmingham UK). Comparison of secondary prevention measures after myocardial infarction in subjects with and without diabetes mellitus. J Intern Med 1999; 245: 565–570.Objectives. To survey and compare secondary prevention measures in diabetic and non‐diabetic patients following myocardial infarction (MI).Design. Follow‐up of a cohort of patients who suffered their first MI 1 year previously.Setting. Three district general hospitals.Main outcome measures. Review 1 year post‐MI for signs of left ventricular failure (LVF), serum cholesterol, smoking status, weight, blood pressure and glycaemic control. Assessment of appropriate treatment with aspirin, beta‐blockers, angiotensin‐converting enzyme (ACE) inhibitors and lipid‐lowering therapy before discharge and at least 1 year post‐MI.Results. A total of 189 non‐diabetic and 86 diabetic patients were studied. Most patients received beta‐blockers and aspirin appropriately, and most gave up smoking. In non‐diabetic subjects, cholesterol fell significantly (P < 0.05), as did the proportion of patients with cholesterol > 5.5 mmol L–1 (P < 0.05), whereas cholesterol did not fall significantly in diabetic subjects, due to a lower proportion of patients being on lipid‐lowering therapy (27.5 vs. 37.9%). A higher proportion of non‐diabetic patients with LVF were treated with ACE inhibitors compared with diabetic subjects (73.6 vs. 61.0%). Glycaemic control did not improve in the diabetic subjects.Conclusions. Patients with diabetes do not receive optimal secondary prevention measures compared with their non‐diabetic counterparts. This issue needs to be addressed by all units dealing with patients with diabetes in order to reduce the mortality and morbidity of MI in such patients.
Declining prevalence of angina pectoris in middle‐aged men and women. A population‐based study within the Northern Sweden MONICA Project
Authors: Glader E.‐L. , Stegmayr B. 
Published: March 2003

Abstract. Glader E‐L, Stegmayr B (University Hospital, Umeå, Sweden). Declining prevalence of angina pectoris in middle‐aged men and women. A population‐based study within the Northern Sweden MONICA Project. J Intern Med 1999; 246: 285–291.Objectives. To describe trends in the prevalence of angina pectoris in northern Sweden, between 1986 and 1994.Design. Cross‐sectional population studies.Setting. Northern Sweden MONICA Project in Norrbotten and Västerbotten counties, Sweden.Subjects. Randomly selected men and women in the age group 35–64 years, total of 2459 men and women.Main outcome measures. Comparison of the prevalence of angina pectoris in 1986 and 1994 as measured by the Rose questionnaire.Results. The proportion with a history of myocardial infarction decreased amongst the participants from 4.6% to 2.0% (P < 0.001) between 1986 and 1994. The prevalence of angina pectoris in men was essentially unchanged (3.4% in 1986 to 3.1% in 1994 (χ2 = 0.02; P = 0.87), whereas it declined significantly in women from 5.9% to 2.8% (χ2 = 6.32; P = 0.01). In both men and women, the highest prevalence of Rose‐positive persons was found in the oldest age group. In 1986 the Rose‐positive subgroup had a significantly higher proportion with high cholesterol (≥6.5 mmol L–1) as compared with the Rose‐negative subgroup, 64% vs. 48% (χ2 = 5.04; P = 0.02). In both surveys high blood pressure was more common in the Rose‐positive group (1986: χ2 = 13.2; P < 0.001 and 1994: χ2 = 9.8; P = 0.002).Conclusions. In women, but not in men, the prevalence of angina pectoris decreased significantly between 1986 and 1994. During the same time period the proportion of people with high cholesterol decreased in northern Sweden. In both surveys, individuals with angina pectoris had more frequent hypertension.
The different effects of a Gln27Glu β2‐adrenoceptor gene polymorphism on obesity in males and in females
Authors: Hellström L. , Large V. , Reynisdottir S. , Wahrenberg H. , Arner P. 
Published: March 2003

Abstract.Objectives. To investigate the role of a polymorphism in codon 27 (Gln27Glu) of the β2‐adrenoceptor gene for obesity in males compared to previously investigated females with an association of this polymorphism to obesity.Design. Population‐based study.Setting. Medical department at a University Hospital.Subjects. A total of 138 non‐related Swedish males with body mass indexes (BMI) in the range 19.4–53.4 kg m−2 were recruited as: healthy volunteers, healthy obese subjects and subjects undergoing surgery for uncomplicated gallstone or abdominal hernia. In order to investigate the impact of gender, the results were compared with a subset of an earlier investigated female population of 109 Swedish females. Obesity was defined as a BMI > 27 kg m−2.Main outcome measures. Genotype examination of β2‐adrenoceptor polymorphism in codon 27 with polymerase chain reaction and restriction fragment length polymorphism.Results. The allele frequency of Gln27 and Glu27 did not differ between males and females when obese and non‐obese subjects were investigated together. However, in obese males, the frequency of the Glu27 allele was significantly decreased (P = 0.034), whereas the frequency of this allele was increased in obese females (P = 0.013). No impact of the female androgen status on the distribution of the Gln27Glu polymorphism could be demonstrated in the obese females.Conclusion. A positive association between obesity and the Glu27 genetic variant in the β2‐adrenoceptor exists in females, whereas in males there is a negative correlation between Glu27 and obesity. The findings suggest that different genetic factors contribute to obesity in males and females.
Evaluation of a computer‐based decision support system for treatment of hypertension with drugs: retrospective, nonintervention testing of cost and guideline adherence
Authors: Persson M. , Mjörndal T. , Carlberg B. , Bohlin J. , Lindholm L. H. 
Published: March 2003

Abstract. Persson M, Mjörndal T, Carlberg B, Bohlin J, Lindholm LH (University of Umeå, Sweden). Evaluation of a computer‐based decision support system for treatment of hypertension with drugs: retrospective, nonintervention testing of cost and guideline adherence. J Intern Med 2000; 247: 87–93.Objective. To evaluate a computerized decision support system (DSS) for drug treatment of hypertension, regarding quality, safety, and cost compared to actual antihypertensive drug treatment.Design. The medical profiles of 338 hypertensive patients treated with drugs against hypertension were processed by the DSS. The drug treatment proposed by the system was then compared to actual treatment given by their physician.Setting. Four health centres in the county of Västerbotten, in Sweden.Subjects. A list of hypertensive patients was extracted from the computerized medical records of each health centre and every fifth patient’s medical profile was assessed by the system.Interventions. None.Main outcome measures. Drug used, drug used in relation to certain major diseases such as diabetes mellitus, asthma, ischaemic heart disease (IHD), and previous myocardial infarction. Adherence to hypertension guidelines, safety, and cost.Results. The DSS suggested significantly more thiazides and significantly fewer calcium antagonists than the physicians had prescribed, with a total cost reduction of 33–40%, depending on doses chosen. The DSS drug profile was more adherent to guidelines in patients with major complicating diseases, suggesting an improvement in treatment quality for these patients by the DSS.Conclusion. The DSS which fully implements current guidelines may improve the quality of antihypertensive treatment, concurrently leading to a considerable reduction in drug costs.
Comparison of biochemical markers for the detection of minimal myocardial injury: superior sensitivity of cardiac troponin – T ELISA
Authors: Lang K. , Börner A. , Figulla H. R. 
Published: March 2003

Objectives. Patients with minimal myocardial injuries who present clinically with unstable angina, early stages of myocardial infarction or myocarditis require different therapy strategies to those without. The newer diagnostic assays for detecting myocardial lesions (cardiac Troponin T and cardiac Troponin I [cTnT, cTnI], glycogenphosphorylase – BB [GPBB]) are reported to be more sensitive and specific than common biochemical markers such as CK and myoglobin. Our study tested whether the recently developed four assays cTnT‐ELISA (in vitro), cTnT rapid bedside assay, cTnI rapid bedside assay, and GPBB (Immunoenzymetric assay) are effective in detecting minimal myocardial injuries caused by endomyocardial biopsy. We compared them with CK activity (CK‐cat), CK‐MB activity (CK‐MBcat), CK‐MB‐concentration (CK‐MB‐mass) and Myoglobin concentration (Myo‐conc.).Patients and methods. Twenty‐four patients [six female, 18 male, age (mean): 47 years (20–65)] underwent diagnostic endomyocardial biopsy. Between four and six biopsies were taken from the mid‐right ventricular aspect of the interventricular septum of the heart. Blood was drawn before catheterization (baseline), 10 min after the biopsy, in the next morning, and in the morning of the second day after (days 1 and 2).Results and Conclusion. Because of very low CKcat it was not possible to analyse CK‐MBcat with reliable precision. The assay for GPBB and cTnI rapid bedside assay did not indicate this minimal myocardial injury. The CK cat, CK‐MB mass, and myoglobin assays indicated significant increase at 10 min after biopsy but remained within reference range. cTnT rapid bedside assay indicated this minimal myocardial injury in 50% (P < 0.05). cTnT‐ELISA (in vitro) was increased above the reference limit in 54%. This increase was 3.6‐fold the upper reference limit (P < 0.01). In our study, due to superior discriminating power, cTnT‐ELISA (in vitro) was the most sensitive assay for minimal myocardial injuries.
The educated patient: new challenges for the medical profession
Authors: Neuberger J. 
Published: March 2003

Abstract. Neuberger J (King’s Fund, London, UK). The educated patient: new challenges for the medical profession (Review). J Intern Med 2000; 247: 6–10.The medical profession is facing significant changes in the way the rest of society relates to it. Mass education, mass media and mass consumerism have boomed in the 20th century, putting an increasing amount of pressure on professionals to meet rising public expectations. If doctors are to continue to provide a service that meets the demands of citizens and taxpayers, they need to develop a new relationship with patients, acting not as instructors but as guides, to help people make decisions about their own health. They will have to be more accountable for the quality of care they provide and work with a wider range of health and non‐health professionals to meet patients’ needs. Doctors need not only to accept the consumer society but also, I will argue, to encourage it. They can work to ensure that the benefits of the information revolution are felt by people excluded from consumerism because of poverty and social isolation, working to create an empowered, informed public whose members are given the best opportunity to look after their own health.
Association of coronary heart disease with age‐adjusted aortocoronary calcification in patients with familial hypercholesterolaemia
Authors: Jensen J. M. , Gerdes L. U. , Jensen H. K. , Christiansen T. M. , Brorholt‐Petersen J. U. , Faergeman O. 
Published: March 2003

Abstract. Jensen JM, Gerdes LU, Jensen HK, Christiansen TM, Brorholt‐Petersen JU, Faergeman O (Aarhus Amtssygehus University Hospital, Aarhus, Denmark). Association of coronary heart disease with age‐adjusted aortocoronary calcification in patients with familial hypercholesterolaemia. J Intern Med 2000; 247: 479–484.Objectives. Existing algorithms of risk of coronary heart disease (CHD) do not pertain to patients with familial hypercholesterolaemia (FH), whose arteries have been exposed to hypercholesterolaemia since birth. We studied a cohort of FH patients to compare four diagnostic models of CHD: traditional risk factors of CHD (age, sex, cholesterol, hypertension, smoking and body mass index), cholesterol year score, and aortic as well as coronary calcium measured by spiral computed tomography (CT).Subjects. We invited 88 individuals with molecularly defined FH of whom 80 (91%) decided to participate.Results. Analysis of receiver operating characteristic curves showed that the age‐adjusted coronary calcium score was more strongly associated with clinical manifestations of CHD than were traditional risk factors (P < 0.002), cholesterol year score (P << 0.0001), and the age‐adjusted aortic calcium score (P < 0.0004).Conclusions. Age‐adjusted coronary calcium score shows promise as an indicator of CHD in FH patients.
Heterogeneity of autoantibodies against cardiolipin and oxidatively modified LDLs revealed by human monoclonal antibodies
Authors: Lefvert A. K. 
Published: March 2003

Abstract. Lefvert AK (Center for Molecular Medicine and Department of Medicine, Karolinska Institutet, Stockholm, Sweden). Heterogeneity of autoantibodies against cardiolipin and oxidatively modified LDLs revealed by human monoclonal antibodies (Minisymposium). J Intern Med 2000; 247: 385–390.Human monoclonal antibodies against cardiolipin, native and oxidatively modified LDL and against apoB100 were obtained by Epstein–Barr virus transformation of peripheral blood mononuclear cells followed by cloning. The antibodies were used to analyse the cross‐reactivity between monoclonals with different specificities and to study the repertoire of antibodies present in sera from patients. Monoclonal antibodies selected for binding to cardiolipin were the least cross‐reactive, whereas antibodies against different modifications of LDL frequently also reacted with other modifications.Inhibition studies showed that serum antibodies against cardiolipin and against oxidatively modified LDL were to a different extent inhibited by the different monoclonal antibodies and thus markedly heterogeneous.
Progress in haematopoietic stem cell transplantation for multiple myeloma
Authors: Gahrton G. , Björkstrand B. 
Published: March 2003

Abstract. Gahrton G. & Björkstrand B. (Departments of Medicine and Hematology, Karolinska Institutet and Huddinge University Hospital, Huddinge, Sweden). Progress in haematopoietic stem cell transplantation for multiple myeloma (Review). J Intern Med 2000; 248: 185–201.High‐dose myeloablative treatment followed by autologous haematopoietic stem cell transplantation has significantly improved survival of patients younger than 65 years of age with multiple myeloma as compared with conventional chemotherapy. However, all patients seem to relapse and molecular remissions are rare.Results of allogeneic transplantation, still hampered by high transplant‐related mortality, have improved dramatically over the last 5–6 years and this is an option for patients younger than 50–55 years old. The relapse rate is lower than with autologous transplantation and molecular remissions are frequent. Some patients are still in complete haematological remission more the 10 years following transplantation.Autologous transplantation followed by nonmyeloablative allogeneic transplantation is on trial and may be a way to eventually cure a fraction of younger patients with multiple myeloma.