bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chlamydia pneumoniae and luminal narrowing after coronary angioplasty
Authors: Mattila K. J. , Juvonen J. T. , Kotamäki M. K. , Saikku P. A. 
Published: March 2003

Mattila KJ, Juvonen JT, Kotamäki MK, Saikku PA (Helsinki University Hospital, Helsinki; Kainuu Central Hospital, Kajaani, and National Public Health Institute, Oulu, Finland). Chlamydia pneumoniae and luminal narrowing after coronary angioplasty. J Intern Med 2001; 250: 67–71. Objectives. Numerous studies have linked Chlamydia pneumoniae with atherosclerotic vessel disease and a trend for an association of the bacteria with restenosis after percutaneous transluminae coronary angioplasty (PTCA) has also been observed. The aim of this study was to assess the role of Chlamydia pneumoniae in the luminal narrowing taking place after PTCA. Design. A noninterventional 6‐month follow‐up study. Setting. A university hospital. Subjects. A total of 122 patients with angiographically proven coronary heart disease (CHD) referred for PTCA. Interventions. None. Main outcome measures. The degree of luminal narrowing in the coronary arteries following coronary angioplasty. Results. The levels of C. pneumoniae antibodies (IgG, IgA and IgM classes) and immune complexes were not associated with luminal narrowing after PTCA in multivariate analyses whilst smoking, plasma endothelin levels and diabetes were. The serologic parameters did not change during the follow up either. Conclusions. These results do not support a role for C. pneumoniae in luminal narrowing following PTCA.
Are patients on long‐term oxygen therapy followed up properly? Data from the Danish Oxygen Register
Authors: Ringbaek T. J. , Lange P. , Viskum K. 
Published: March 2003

Abstract. Ringbaek TJ, Lange P, Viskum K (University Hospital of Copenhagen, Hvidovre Hospital; and Gentofte Hospital; Copenhagen, Denmark). Are patients on long‐term oxygen therapy followed up properly? Data from the Danish Oxygen Register. J Intern Med 2001; 250: 131–136. Objectives. The aim of the study was to assess the extent and quality of follow‐up of patients on LTOT. Setting. The Danish Oxygen Register. Subjects. A total of 890 chronic obstructive pulmonary disease (COPD) patients who were on long‐term oxygen therapy (LTOT) during the period from 1 November 1994 to 31 August 1995. Main outcome measures. The extent and quality of follow‐up. Results. Only 38.5% of the patients were followed up in the study period, and only 17.5% had a ‘sufficient follow‐up’ defined as at least one follow‐up visit within 10 months which included measurement of arterial blood gases or pulsoximetry with oxygen supply, verification that the patient used oxygen ≥15 h day–1 and was nonsmoker. Female gender, LTOT initiated 3–12 months ago, LTOT started by a chest physician at pulmonary department and LTOT prescribed ≥15 h day–1 were found to be significant predictors of ‘sufficient follow‐up’ (odds ratio (OR): 1.7, 2.0, 3.7 and 1.9, respectively). Conclusions. The extent and the quality of follow‐up of patients on LTOT were poor, especially if a nonpulmonary physician initiated LTOT. We recommend that more attention should be paid on proper monitoring of LTOT, and that only chest physicians should be able to prescribe and re‐evaluate LTOT.
Antineutrophil cytoplasmatic antibodies in patients with premature atherosclerosis: prevalence and association with risk factors
Authors: VAN HAELST P. L. , ASSELBERGS F. W. , VAN DOORMAAL J. J. , VEEGER N. J. G. M. , MAY J. F. , HOLVOET P. , GANS R. O. B. , TERVAERT J. W. COHEN 
Published: March 2003

Abstract. van Haelst PL, Asselbergs FW, van Doormaal JJ, Veeger NJGM, May JF, Holvoet P, Gans ROB, Cohen Tervaert JW (University Hospital Groningen, Groningen, The Netherlands; University of Leuven, Leuven, Belgium). Antineutrophil cytoplasmatic antibodies in patients with premature atherosclerosis: prevalence and association with risk factors. J. Intern Med 2002; 251: 29–34. Objectives. Autoimmunity is suggested to play a role in premature atherosclerosis. Antineutrophil cytoplasmatic antibodies (ANCA) are a group of autoantibodies found in several inflammatory disorders in which they supposedly amplify the inflammatory process. In this study the hypothesis is tested that ANCA play a role in premature atherosclerosis. Design. Cross‐sectional study followed by nested case–control study. In a total of 286 consecutive patients with premature atherosclerosis (age < 55 years) ANCA were tested. Within the same cohort, a nested case–control study in 16 ANCA‐positive patients and 32 ANCA‐negative controls matched for sex, and site of atherosclerosis, was executed. Setting. University hospital outpatient clinic for lipids and premature atherosclerosis. Subjects. A total of 286 consecutive patients with premature atherosclerosis (age < 55 years). Results. Prevalence of ANCA was 5.6% (16 of 286). All cases had perinuclear ANCA (pANCA); no cytoplasmatic ANCA was found. Mean age was 42 ± 7 in the ANCA‐positive vs. 42 ± 9 years in the ANCA‐negative group (P=ns). More female parents were ANCA‐positive (8M/8F vs. 200M/70F, P=0.03). Patients with ANCA had more often peripheral vascular disease (37.5 vs. 15.2%, P=0.03). In the case–control study levels of Lp(a) were higher (43.8 vs. 15.6% >300 mg L−1, P=0.05), whereas levels of HDL‐c were lower in ANCA‐positive patients (0.84 ± 0.26 vs. 1.06 ± 0.27 mmol L−1, P=0.01). Markers of inflammation, C‐reactive protein (CRP) and serum amyloid A (SAA), did not differ, nor did antibodies against oxidized‐LDL and malondialdehyde (MDA)‐LDL, markers for the extent of atherosclerosis. Conclusions. Our results suggest that ANCA do not appear to play a major role in premature atherosclerosis as there was no increased prevalence of the autoantibody. Moreover, no differences in the incidence of classical cardiovascular risk factors nor in serum levels of markers of inflammation were found between the ANCA‐positive group as compared with the ANCA‐negative group.
Exploring sex differences in case fatality in acute myocardial infarction or coronary death events in the northern Sweden MONICA Project
Authors: Lundberg V. , Wikström B. , Boström S. , Asplund K. 
Published: March 2003

Abstract. Lundberg V, Wikström B, Boström S, Asplund K (Kalix Hospital and Umeå University Hospital, Sweden). Exploring sex differences in case fatality in acute myocardial infarction or coronary death events in the northern Sweden MONICA Project. J Intern Med 2002; 251: 235–244. Objectives. To investigate sex differences in reaching diagnosis, medical management and case fatality (CF) in acute myocardial infarction (AMI) in the population aged 35–64 years in northern Sweden. Methods. Within the framework of the World Health Organization Multinational Monitoring of Trends and Determinants in Cardiovascular Diseases (MONICA) Project, definite AMI was monitored in people aged 35–64 years from 1989 through 1995 (target population 510 000 in 1991). Setting. In a population based coronary register, all coronary events were recorded in nine hospitals in 1989–95. Results. The number of events included in the definite coronary myocardial infarction register was 2483 men and 669 women. On admission, a higher proportion of men with definite AMI had chest pain or ECG changes typical for AMI (P < 0.0001). Disagreement between clinical diagnosis and classification by MONICA criteria occurred more often in women (P=0.008). A significantly higher proportion of men was admitted in the coronary care unit and they were significantly more often treated with thrombolytics, nitroglycerine, β‐blockers, or antiplatelet agents. Women received significantly more diuretics, inotropics or calcium antagonists. Diabetes, conferring a worse prognosis, was more common in women (20 vs. 15%; P=0.003). Prehospital CF was significantly higher in men (24.1 vs. 18.3%; P=0.005), but in patients treated in hospital, the CF was significantly lower in men (12.7 vs. 21.2%; P < 0.001). Total CF was equal in men and women. Conclusions. Several factors contributing to the excess in‐hospital CF in women were identified, including greater problems in diagnosis of AMI in women which may be one of the reasons for less intensive treatment in women. Differences in co‐morbidity, most notably diabetes and medical treatment between men and women with acute AMI may also have played a part.
On the diagnosis of polycythaemia vera as assessed in the health and medical care in the Västra Götaland region, Sweden
Authors: JOHANSSON P. , ANDRÉASSON B. , SAFAI‐KUTTI S. , RHEDIN C. , VILÉN L. , VÄÄRT J. , KUTTI J. 
Published: March 2003

Abstract. Johansson P, Andréasson B, Safai‐Kutti S, Rhedin C, Vilén L, Väärt J, Kutti J (Sahlgrenska University Hospital, Göteborg; Uddevalla Hospital, Uddevalla; Borås Hospital, Borås; and Skövde Hospital, Skövde; Sweden). On the diagnosis of polycythaemia vera as assessed in the health and medical care in the Västra Götaland region, Sweden. J Intern Med 2002; 251: 348–354. Objective. The aim was to assess how the diagnosis of polycythaemia vera (PV) was established and to study to which extent the classic Polycythemia Vera Study Group (PVSG) criteria and the revised criteria for the diagnosis of PV as proposed by Pearson and Messinezy in 1996 (PM criteria) were fulfilled when the diagnosis of PV was made. Design and setting. A questionnaire was sent to physicians in charge of haematological patients at the departments of medicine in 12 hospitals in the Health and Medical Care in the Västra Götaland Region (VGR), Sweden, with a population of 1.5 million inhabitants; they were asked to provide reports as regards all patients with an unequivocal diagnosis of PV during a 5‐year period from January 1994 to December 1998. Subjects. Full reports were obtained from six hospitals, which serve about 1.1 million inhabitants. The results from a total of 129 PV patients, 62 from two university hospitals (UHs) and 67 from four county hospitals (CHs), were the subject of the present analysis. Results. It was shown that measurement of the red cell mass (RCM) had been carried out in 61 of 62 (98%) patients in UHs compared with 24 of 67 (36%) patients at CHs (P < 0.01). By using ultrasound imaging and/or scintigraphy the spleen size had been determined in 55 of 62 (89%) patients at UHs and in 24 of 67 (36%) patients at CHs (P < 0.01). At the UHs, arterial oxygen saturation had been measured in 32 of 62 (52%) patients; the corresponding figure for the CH patients was 22 of 67 (33%). Plasma or serum erythropoietin (EPO) concentrations had been measured in 44 of 62 (71%) of PV patients at UHs and in 31 of 67 (46%) of patients at CHs; in all these cases the EPO concentrations were subnormal or not measurable. Conclusions. At the UHs only 37% of the PV patients fulfilled the PVSG criteria for the diagnosis of PV whereas the corresponding figure for CHs was 4% (P < 0.01). The adherence to PM criteria was, however, 71% at UHs compared with 16% at CHs (P < 0.01).
Factors predicting a hospital stay of over 3 days in patients with acute exacerbation of chronic obstructive pulmonary disease
Authors: De La Iglesia F. , Valiño P. , Pita S. , Ramos V. , Pellicer C. , Nicolás R. , Diz‐Lois F. 
Published: March 2003

Abstract. de la Iglesia F, Valiño P, Pita S, Ramos V, Pellicer C, Nicolás R, Diz‐Lois F (Juan Canalejo Hospital, A Coruña, Spain). Factors predicting a hospital stay of over 3 days in patients with acute exacerbation of chronic obstructive pulmonary disease. J Intern Med 2002; 251: 500–507. Objective. To investigate the factors predicting a hospital stay of over 3 days in patients who required hospitalization for acute exacerbation of chronic obstructive pulmonary disease (COPD). Design and setting. A cross‐sectional tudy was done at a tertiary hospital serving an area of 500 000 inhabitants. Subjects. A total of 273 patients (α=0.05; accuracy=5.94%) who had been admitted consecutively to the Short Stay Medical Unit at the Juan Canalejo Hospital in A Coruña, from February 1998 to March 1999, with a diagnosis focusing on exacerbation of COPD. Methods. Demographic variables, past medical history, symptoms, arterial blood gases, functional tests, treatment and the cause of exacerbation were studied in each patient. The hospital stay was dichotomized into ≤3 vs. >3 days. The prognostic factors of a hospital stay were determined by log regression. Results. The mean stay was 4.6 ± 5.1 days (range: 1–64). After monitoring the associated covariables, the following were found to have an independent effect on the prediction of a hospital stay of over 3 days: weekend admissions (OR=4.17; 95% CI: 2.42–7.18), the presence of cor pulmonale (OR=2.19; 95% CI: 1.27–3.78), and the respiratory rate on admission (OR=1.09; 95% CI: 1.03–1.14). Arterial blood gases and functional tests showed no independent effect. Conclusions. The factors having an independent prognostic value in determining the length of hospital stays in patients with COPD are weekend admission, cor pulmonale and respiratory rate. Additional studies are required to validate these findings.
Cutaneous gene transfer for skin and systemic diseases
Authors: KHAVARI P. A. , ROLLMAN O. , VAHLQUIST A. 
Published: March 2003

This article is partially based on the findings presented at a symposium on Cutaneous Gene Therapy, held in Uppsala, September 2001, and abstracted in Acta Derm Venereol 81: 227–239. Abstract. Khavari PA, Rollman O, Vahlquist A (Stanford University School of Medicine, Stanford, CA, USA; and Department of Medical Sciences, Dermatology, Uppsala University, Uppsala, Sweden). Cutaneous gene transfer for skin and systemic diseases (Review). J Intern Med 2002; 252: 1–10.Recent progress in molecular genetics has illuminated the basis for a wide variety of inherited and acquired diseases. Gene therapy offers an attractive therapeutic approach capitalizing upon these new mechanistic insights. The skin is a uniquely attractive tissue site for development of new genetic therapeutic approaches both for its accessibility as well as for the large number of diseases that are amenable in principle to cutaneous gene transfer. Amongst these opportunities are primary monogenic skin diseases, chronic wounds and systemic disorders characterized by low or absent levels of circulating polypeptides. For cutaneous gene therapy to be effective, however, significant progress is required in a number of domains. Recent advances in vector design, administration, immune modulation, and regulation of gene expression have brought the field much nearer to clinical utility.
Development of hypertension over 6 years in a birth cohort of young middle‐aged men: the Cardiovascular Risk Factor Study in southern Sweden (CRISS)
Authors: HENRIKSSON K. M. , LINDBLAD U. , GULLBERG B. , ÅGREN B. , NILSSON‐EHLE P. , RÅSTAM L. 
Published: March 2003

Abstract. Henriksson KM, Lindblad U, Gullberg B, Ågren B, Nilsson‐Ehle P, Råstam L (Lund University, Skaraborg Institute and Helsingborg County Hospital, Sweden). Development of hypertension over 6 years in a birth cohort of young middle‐aged men: the Cardiovascular Risk Factor Study in southern Sweden (CRISS). J Intern Med 2002; 252: 21–26. Objectives. To explore the development of hypertension (HT) in a cohort of young middle‐aged men. Design. Prospective birth‐cohort study of men surveyed over 6 years. Setting. Helsingborg County Hospital, Sweden, 1990–97. Subjects. A total of 628 men born in 1953–54, all surveyed at 37, 40 and 43 years of age. Main outcome measures. Systolic blood pressure (SBP), diastolic blood pressure (DBP), S‐cholesterol, body mass index (BMI), alcohol consumption, ethnicity. HT was defined as SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg, or ongoing treatment. Using SBP < 130 mmHg and DBP < 85 mmHg as reference, the odds of conversion to HT in men with high normal blood pressure (BP) (SBP 130–139 mmHg and DBP 85–89 mmHg) was investigated. Results. At age 37, 243 men (39%) had reference BP, 167 (26%) had high normal BP and 218 (35%) were hypertensive. Corresponding numbers at age 40 were 265 (42%), 166 (27%) and 197 (31%); and at age 43, 180 (29%), 142 (22%) and 306 (49%), respectively. High normal BP at baseline was associated with the development of HT both at age 40 (odds ratio (OR)=2.45 confidence interval (CI): 1.42–4.22) and at age 43 (OR=2.46, CI: 1.59–3.80), independent of other cardiovascular disease risk factors and ethnicity. The progression to HT was predicted also by S‐cholesterol, alcohol consumption, BMI and weight gain. Conclusions. Over a short‐term period, a substantial proportion of young middle‐aged men with high normal BP develop HT with overweight and alcohol consumption as important determinants. These findings have implications for the prevention, screening and medical care of HT in this target population.
Kikuchi–Fujimoto's disease: report of familial occurrence in two human leucocyte antigen‐identical non‐twin sisters
Authors: AMIR A. R. A. , AMR S. S. , SHEIKH S. S. 
Published: March 2003

Abstract. Amir ARA, Amr SS, Sheikh SS (Dhahran Health Center, Saudi Arabia). Kikuchi–Fujimoto's disease: report of familial occurrence in two human leucocyte antigen‐identical non‐twin sisters (Case Report). J Intern Med 2002; 252: 79–83.Kikuchi–Fujimoto's disease (KFD) is a self‐limiting condition usually presenting as cervical lymphadenopathy, with fever and leukopenia, in young adult females. No specific aetiology has been identified yet, although some authors believe that KFD is a `forme fruste' of systemic lupus erythematosus. Certain human leucocyte antigen (HLA) types have also been associated with KFD.We herein report KFD in two non‐twin sisters with HLA‐identical phenotype, who presented 10 years apart. Neither patient had evidence of recent infection or connective tissue disease. The familial occurrence emphasizes the possibility of genetic predisposition and calls for a more extensive search for a specific cause of KFD.
Residual insulin secretion is not coupled to a maintained glucagon response to hypoglycaemia in long‐term type 1 diabetes
Authors: Sjöberg S. , Ahrén B. , Bolinder J. 
Published: March 2003

Objectives.  To evaluate the influence of residual β‐cell function on glucagon secretion and glucose counter‐regulation following hypoglycaemia in type 1 diabetes.Design and subjects.  The hormonal counter‐regulatory responses to standardized insulin‐induced hypoglycaemia were investigated, 18 patients with type 1 diabetes of long duration and 12 healthy subjects were investigated. Nine of the diabetic patients (diabetes duration 17 ± 1 years) had residual insulin secretion, as reflected by persistent urinary C‐peptide excretion. The other nine diabetic patients (diabetes duration 21 ± 1 years) were C‐peptide negative.Results.  Similar hypoglycaemic nadirs were found in all groups (2.1–2.3 mmol L−1), whereas the recovery of plasma glucose levels was delayed similarly in the diabetic groups. In the control subjects, plasma glucagon increased (∼50%). No significant glucagon response was registered in either of the two diabetic groups. The maximum plasma adrenaline and pancreatic polypeptides (PP) responses to hypoglycaemia were comparable in the two diabetic patient groups; the peak values being lower (P < 0.05) than in the controls. Plasma noradrenaline, growth hormone and cortisol responses to hypoglycaemia were similar in all three groups.Conclusion.  Residual β‐cell function in patients with long‐term type 1 diabetes is not accompanied by preservation of the glucagon response to hypoglycaemia. As the two markers of autonomic function (adrenaline and PP) were similarly reduced in the two diabetic groups, the findings instead favour the concept that the defective glucagon secretory response to hypoglycaemia is because of autonomic nervous dysfunction.
Longitudinal bone loss in postmenopausal women with primary biliary cirrhosis and well‐preserved liver function
Authors: Ormarsdóttir S. , Ljunggren Ö. , Mallmin H. , Olsson R. , Prytz H. , Lööf L. 
Published: March 2003

Abstract.  Ormarsdóttir S, Ljunggren Ö, Mallmin H, Olsson R, Prytz H, Lööf L (University Hospital, Uppsala; Sahlgrenska University Hospital, Gothenburg; University Hospital, Lund; and Central Hospital, Västerås, Sweden). Longitudinal bone loss in postmenopausal women with primary biliary cirrhosis and well‐preserved liver function. J Intern Med 2002; 252: 537–541.Objectives/design.  Increased rate of bone loss has been reported in women with primary biliary cirrhosis (PBC) and varying degree of liver dysfunction. Whether bone loss is increased in patients without liver dysfunction is unclear. The aim of this study was to estimate retrospectively the rate of bone loss in postmenopausal women with PBC and well‐preserved liver function.Subjects/interventions.  Forty‐three women with PBC, and classified as Child‐Pugh class A, were included. Bone mineral density (BMD) was measured by dual energy X‐ray absorptiometry at the lumbar spine and the femoral neck.Results.  Median time between measurements of BMD was 26 months (range, 12–48 months). Twenty women were not receiving any bone protective treatment, i.e. hormone replacement therapy (HRT), bisphosphonates or vitamin D/calcium supplementation, whilst 23 women received such treatment. Mean annual bone loss in the former group was 0.38 ± 2.56% and 0.42 ± 2.29% at the lumbar spine and the femoral neck, respectively. Women receiving treatment, however, increased their BMD by 1.92 ± 3.76% and 0.15 ± 2.75% at the lumbar spine and the femoral neck, respectively. At the lumbar spine the difference with regard to changes in BMD between untreated and treated women was statistically significant (P = 0.02). Women who received HRT (n = 11) increased their BMD at the lumbar spine by 2.95 ± 3.91%, P = 0.03 when compared with untreated women.Conclusion.  Bone loss in postmenopausal women with PBC and well‐preserved liver function is not increased above normal. Treatment with bone protective treatment, mainly HRT, improves BMD at the lumbar spine.
Bezafibrate‐induced improvement in glucose uptake and endothelial function in protease inhibitor‐associated insulin resistance
Authors: Nyström T. , Bratt G. , Sjöholm Å. 
Published: March 2003

Abstract.  Nyström T, Bratt G, Sjöholm Å (Karolinska Institutet, Stockholm South Hospital, Stockholm, Sweden). Bezafibrate‐induced improvement in glucose uptake and endothelial function in protease inhibitor‐associated insulin resistance (Case Report). J Intern Med 2002; 252: 570–574.Protease inhibitors used as therapy for HIV‐1 infection have been associated with metabolic side‐effects such as peripheral fat wasting, central adiposity, hyperlipidaemia and insulin resistance. This metabolic disorder is known as the lipodystrophy syndrome. This syndrome can be recognized by the early appearance of an increase in serum triglyceride, cholesterol and plasma‐free fatty acid levels. Here, we describe an HIV‐1 positive patient with the lipodystrophy syndrome in whom a decline in serum triglycerides was seen along with a significant improvement in glucose uptake following treatment with bezafibrate for 3 months. This improvement may be a consequence of the Randle effect, i.e. increased availability of plasma‐free fatty acids is negatively correlated to glucose uptake. We also noted a significant improvement in endothelial‐dependent flow‐mediated dilatation after treatment with bezafibrate. This effect could result from the increased glucose uptake observed and a decrease in insulin resistance secondary to the lowered triglyceride levels by bezafibrate. We conclude that bezafibrate may be of clinical utility in the lipodystrophy syndrome, through its beneficial effects on insulin resistance, glucose uptake and endothelial dysfunction.