bluuebunny/crossref_metadata_2025_split huggingface dataset:
The EWA (Estrogen in Women with Atherosclerosis) Study: a randomized study of the use of hormone replacement therapy in women with angiographically verified coronary artery disease. Characteristics of the study population. Effects on lipids and lipoproteins
Authors: Os I. , Hofstad A. E. , Brekke M. , Abdelnoor M. , Nesheim B. I. , Jacobsen A. F. , Birkeland K. , Larsen A. , Midtbø K. , Westheim A. 
Published: March 2003

Abstract. Os I, Hofstad AE, Brekke M, Abdelnoor M, Nesheim BI, Jacobsen AF, Birkeland K, Larsen A, Midtbø K, Westheim A (Ullevaal University Hospital and Aker University Hospital, Oslo, Norway). The EWA (Estrogen in Women with Atherosclerosis) Study: a randomized study of the use of hormone replacement therapy in women with angiographically verified coronary artery disease. Characteristics of the study population. Effects on lipids and lipoproteins. J Intern Med 2000; 247: 433–441.Objectives. To evaluate the effects of hormone replacement therapy (HRT) on lipids and lipoproteins in postmenopausal women with coronary artery disease.Setting. In this single‐centre, controlled and randomized study taking place in a tertiary referral clinic, patients were examined at baseline, and after 3 and 12 months. All analyses were performed examiner‐blind.Subjects. Postmenopausal women (n = 118) with angiographically verified coronary artery disease were recruited consecutively from patients referred for investigational procedures due to coronary artery disease.Interventions. The women were randomized to HRT, i.e. transdermal application of continuous 17‐β oestradiol with cyclic medroxyprogesterone actetate tablets every 3rd month for 14 days, or to a control group.Main outcomes. Effects on lipids and lipoproteins.Results. After 3 months of unopposed oestradiol, triglycerides decreased significantly compared to the control group (P = 0.006). Sequential administration of medroxyprogesterone caused a decrease in HDL cholesterol (P = 0.01), concomitantly with a decrease in ApoA1 lipoproteins (P = 0.007). No other changes in lipids or lipoproteins were observed. After 12 months of therapy, no significant differences were observed between the two groups in lipid or lipoprotein levels. Concomitant statin treatment did not alter the main findings.Conclusions. In postmenopausal women with established coronary artery disease in whom the majority is treated with statins, no additional effect of HRT on lipids or lipoproteins could be observed except for a transient decrease in triglycerides in the initial unopposed oestradiol phase. No deleterious effect could be observed during medroxyprogesterone administration except for a small transient decrease in HDL cholesterol and ApoA1 lipoproteins.
Desmopressin and hexarelin tests in alcohol‐induced pseudo‐Cushing’s syndrome
Authors: Coiro V. , Volpi R. , Capretti L. , Caffarri G. , Chiodera P. 
Published: March 2003

Abstract. Coiro V, Volpi R, Capretti L, Caffarri G, Chiodera P (University of Parma, Parma, the Hospital of Codogno, Codogno and the Hospital of Guastalla, Guastalla, Italy). Desmopressin and hexarelin tests in alcohol‐induced pseudo‐cushing’s syndrome. J Intern Med 2000; 247: 667–673.Background. A challenge in clinical endocrinology is the distinction between Cushing’s disease (Cushing’s syndrome dependent by adrenocorticotrophic hormone (ACTH)‐secreting tumours of pituitary origin) and alcohol‐dependent pseudo‐Cushing’s syndrome. Patients with Cushing’s disease are known to have high ACTH/cortisol responses to desmopressin (DDAVP, a vasopressin analogue) and to hexarelin (HEX, a synthetic GH‐releasing peptide).Objective. To compare the ACTH/cortisol responses to desmopressin and to hexarelin of subjects with alcohol pseudo‐Cushing’s syndrome with those obtained in patients with Cushing’s disease and in normal controls.Design. Randomized, single‐blind study.Setting. University medical centre.Subjects. Eight alcoholics with pseudo‐Cushing’s syndrome, six patients with Cushing’s disease and nine age‐matched normal controls.Intervention. Three tests at weekly intervals. The dexamethasone (1 mg) suppression test (DST) was carried out first. The desmopressin (10 μg intravenously at 09:00 h) test and hexarelin (2 μg kg–1 intravenously at 09:00 h) test were carried out in random order.Measurements. Plasma ACTH and cortisol levels.Results. The basal plasma levels of ACTH and cortisol were significantly lower in normal subjects than in patients with Cushing’s disease and in alcoholic subjects; these latter groups showed similar basal hormonal values. All normal controls, two patients with Cushing’s disease and two alcoholics showed suppression of plasma cortisol levels (<5 μg dL–1) after dexamethasone administration. Both desmopressin and hexarelin induced striking ACTH/cortisol responses in patients with Cushing’s disease, whereas hexarelin, but not desmopressin, slightly increased ACTH/cortisol secretion in the normal controls. Neither desmopressin nor hexarelin administration induced any significant change in ACTH/cortisol secretion in alcoholics.Conclusions. These data suggest that either the hexarelin or desmopressin test can be used to differentiate patients with Cushing’s disease from subjects with alcohol‐dependent pseudo‐Cushing’s syndrome.
Independent importance of psychosocial factors for prognosis after myocardial infarction
Authors: Welin C. , Lappas G. , Wilhelmsen L. 
Published: March 2003

Abstract. Welin C, Lappas G, Wilhelmsen L (Heart and Lung Institute, Göteborg University, Göteborg, Sweden). Independent importance of psychosocial factors for prognosis after myocardial infarction. J Intern Med 2000; 247: 629–639.Aims. As a primary aim it was tested whether the 10‐year prognosis after a myocardial infarction is related to psychological stress, lack of social support, anxiety, and/or depressive tendency. A secondary aim was to analyse the prognostic importance of a series of other psychosocial factors as well as interactions.Methods. Non‐selected patients aged below 65 years with a first infarction (230 men and 45 women) were followed for 10 years with 100% assessment of morbidity and cause‐specific mortality. Baseline somatic and psychosocial variables were collected with the aid of standard, validated questionnaires.Results. In multivariate analysis, factors increasing risk for coronary mortality included female sex
(hazard ratio, ± 95% confidence interval) 2.47 (1.06, 5.71), signs of left ventricular failure 3.93 (1.87, 8.26), ventricular dysrhythmia 3 months after the infarction 5.45 (2.21, 13.42), high depression scores 3.16 (1.38, 7.25) and lack of social support 2.75 (1.29, 5.89). All‐cause mortality was significantly related to left ventricular failure, ventricular dysrhythmias, and high depression scores with borderline significance for female sex and social support. Prognosis was affected during the entire follow‐up period. It was not significantly associated with age, marital status, education, extra work, mental strain at work or in the marriage, anxiety, dissatisfaction with family life, problems with children, dissatisfaction with the financial situation, life events, anger‐in, irritability, type A behaviour, or health locus of control. Incidence of nonfatal infarction was not associated with any of the baseline variables.Conclusion. In addition to known somatic predictors of prognosis after a myocardial infarction, prognosis is strongly influenced by depression and lack of social support, but not to a series of other psychosocial factors. It is recommended to use self‐reporting scales to detect prognostically important psychosocial problems.
Risk assessment in patients with acute myocardial infarction treated with thrombolytic therapy
Authors: Jensen‐Urstad M. , Samad B. A. , Jensen‐Urstad K. , Hulting J. , Ruiz H. , Bouvier F. , Höjer J. 
Published: March 2003

Abstract. Jensen‐Urstad M, Samad BA, Jensen‐Urstad K, Hulting J, Ruiz H, Bouvier F, Höjer J (Karolinska Hospital, Karolinska Institute, Stockholm; Söder Hospital, Karolinska Institute, Stockholm; Karolinska Hospital, Karolinska Institute, Stockholm; and Söder Hospital, Karolinska Institute, Stockholm, Sweden). Risk assessment in patients with acute myocardial infarction treated with thrombolytic therapy. J Intern Med 2001; 249: 527–537. Objective. Several noninvasive methods have prognostic information regarding mortality and new coronary events after an acute myocardial infarction (AMI). The practical for clinical decision‐making in the immediate postmyocardial infarction (MI) period is, however, less evident. We investigated consecutive patients with AMI treated with thrombolysis to further clarify this issue. Design. A total of 100 patients (27% women) aged 64 ± 9 years (mean ± SD) were studied. Risk assessment based on a clinical score system, myocardial perfusion scintigraphy single photon emission computed tomography (SPECT) at rest and during adenosine stress, echocardiography, radionuclide angiography, symptom‐limited exercise stress test, and 24‐h Holter ECG recording with ST‐analysis and analysis of heart rate variability (HRV) were performed 5–8 days after hospital admission. Mortality, nonfatal reinfarction, and the need for revascularization were followed during 12 months. Setting. A university hospital. Results. A total of 6 patients died, seven had a nonfatal reinfarction, and 23 were revascularized. Inability to perform an exercise test (P=0.004) and an ejection fraction (EF) <40% (P=0.002) were the only parameters separating those who died from the survivors. No method could predict a nonfatal reinfarction. Patients suffering either death or nonfatal reinfarction had a clinical risk assessment score 2 points higher (8.8 vs. 6.7, P=0.05) than the group without such events. A positive symptom‐limited exercise stress test (P=0.027), ST‐depressions on Holter ECG (P=0.04), and reversibility on myocardial perfusion scintigraphy (P=0.029) predicted the need for revascularization. Conclusion. Risk assessment based on clinical information, exercise stress testing, and an estimate of left ventricular function (e.g. via echocardiography) contribute with prognostic information in thrombolysed MI‐patients. Additional noninvasive investigations such as adenosine‐SPECT, analysis of HRV, and Holter‐monitoring do not add to these commonly available tools in risk stratification of subjects at low to medium risk.
Effects of thiazide‐ and loop‐diuretics, alone or in combination, on calcitropic hormones and biochemical bone markers: a randomized controlled study
Authors: Rejnmark L. , Vestergaard P. , Heickendorff L. , Andreasen F. , Mosekilde L. 
Published: March 2003

Abstract. Rejnmark L, Vestergaard P, Heickendorff L, Andreasen F, Mosekilde L (Aarhus University, Aarhus, Denmark). Effects of thiazide‐ and loop‐diuretics, alone or in combination, on calcitropic hormones and biochemical bone markers: a randomized controlled study (Original study). J Intern Med 2001; 250: 144–153. Objective. Diuretics are commonly used drugs that in addition to their effect on the cardiovascular system also affect calcium homeostasis and bone metabolism. We evaluated the effects of loop diuretics (LD) and thiazide diuretics (TD) on calcitropic hormones and biochemical bone markers. Design. A total of 50 postmenopausal women were randomized to 7 days of treatment with either the TD bendroflumethiazide, the LD bumetanide, bendroflumethiazide plus bumetanide, or placebo. Blood and urine (24 h) were sampled on each day. Statistical inferences were made versus the concomitant changes in the placebo group. Results. Bendroflumethiazide increased the tubular reabsorption of calcium (TRCa) (+0.46 ± 0.11%, P=0.009), plasma levels of parathyroid hormones (PTH) (+24 ± 10%, P=0.06), and 1,25(OH)2D (+12 ± 6%, P=0.03). Bumetanide decreased the TRCa (–0.5 ± 0.1%, P=0.01) and increased plasma PTH and 1,25(OH)2D levels (+27 ± 9%, P=0.02 and +36 ± 12%, P=0.006, respectively). Treatment with either of the drugs did not alter plasma calcium, osteocalcin, bone alkaline phosphatase (bone‐ALP) or urinary NTx/creatinine ratio. However, treatment with both drugs caused an increased plasma calcium level (+2.7 ± 1.0%, P=0.007) and decreased plasma levels of bone‐ALP (–21 ± 3%, P=0.001), osteocalcin (–6 ± 3%, P=0.03), and urinary NTx/creatinine ratio (–39 ± 6%, P=0.001). Conclusion. Calcium homeostasis and bone metabolism are to a major degree influenced by diuretic treatment. Surprisingly, LD and TD exerted a similar effect on calcitropic hormones despite their opposite effects on the renal calcium excretion. In clinical practice, treatment with diuretics has to be considered as a cause of parathyroid stimulation.
High‐dose intravenous immunoglobulin in the treatment of acute myocarditis. A case report and review of the literature
Authors: Tedeschi A. , Airaghi L. , Giannini S. , Ciceri L. , Massari F. M. 
Published: March 2003

Abstract. Tedeschi A, Airaghi L, Giannini S, Ciceri L, Massari FM (IRCCS Ospedale Maggiore Policlinico, Milan, Italy). High‐dose intravenous immunoglobulin in the treatment of acute myocarditis. A case report and review of the Literature. J Intern Med 2002; 251: 169–173.A few reports have suggested the beneficial effect of high‐dose intravenous immunoglobulin (IVIG) in the treatment of acute myocarditis and cardiomyopathy. We describe a 49‐year‐old woman in which acute myocarditis was diagnosed on the basis of clinical and echocardiographic findings. Conventional treatment with captopril and frusemide was administered; intravenous heparin and, subsequently, oral anticoagulants were added because of the appearance of an apical thrombus. On the fifth day of hospitalization, treatment with high‐dose (400 mg kg−1 day−1) IVIG was started and prosecuted for 5 days. A dramatic improvement of clinical conditions was observed, with increase of the left ventricular ejection fraction (LVEF) from 30% to 75% within 1 week. One year after the diagnosis the patient is in good health, with steady normal LVEF. The rapid recovery, which was immediately subsequent to the administration of high‐dose IVIG, suggests that this kind of treatment has been effective in our patient with acute myocarditis.
The cost‐effectiveness of ramipril in the treatment of patients at high risk of cardiovascular events: a Swedish sub‐study to the HOPE study
Authors: Björholt I. , Andersson F. L. , Kahan T. , Östergren J. 
Published: March 2003

Abstract. Björholt I, Andersson FL, Kahan T, Östergren J (AstraZeneca Sverige AB, Mölndal, Sweden/Institute of Surgical Sciences, Göteborg University, Sahlgrenska University Hospital, Göteborg, Sweden; AstraZeneca R & D Lund, Lund, Sweden; Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden; and Karolinska Hospital, Stockholm, Sweden) The cost‐effectiveness of ramipril in the treatment of patients at high risk of cardiovascular events: a Swedish sub‐study to the hope study. J Intern Med 2002; 251: 508–517. Objective. To evaluate if long‐term treatment with ramipril is cost‐effective in patients at high risk of cardiovascular events. Design. Randomized double‐blind and placebo controlled. Information was gathered prospectively for a number of direct medical, direct nonmedical and indirect costs. Setting and subjects. This is a sub‐study to the Heart Outcomes Prevention Evaluation (HOPE) study performed in Swedish patients. All Swedish centres (19; n= 554) were invited to take part and 18 centres agreed to do so (n=537). The patients were managed in a specialist setting with a mean follow‐up period of 4.5 years. Main outcome measures. The number of life‐years saved was derived from the global HOPE study (n=9297) and subsequently the estimated life expectancy of those who completed the clinical study alive was added to the calculation. Direct medical costs related to cardiovascular disease only were considered in the primary analysis, whilst all kinds of costs and costs for all kinds of diseases were included in subsequent analyses. The cost of added years of life, according to the future cost method, was included in sensitivity analyses. Results. The cost per life‐year gained was SEK 16 600 (Euro 1940) when direct medical costs for cardiovascular reasons only were considered and SEK 45 400 (Euro 5300) when direct medical costs for all diseases were considered. The corresponding costs when direct nonmedical and indirect cost were added to the estimate were SEK 16 100 (Euro 1880) and SEK 54 600 (Euro 6380), respectively. When the future cost method was applied, the cost per life‐year gained was SEK 208 300 (Euro 24 300). Conclusion. Ramipril is highly cost‐effective in the treatment of patients at high risk of cardiovascular events.
Exacerbated chronic obstructive pulmonary disease: a frequently unrecognized condition
Authors: INCALZI R. ANTONELLI , FUSO L. , SERRA M. , BASSO S. , CAROSELLA L. , TRAMAGLINO L. M. , PISTELLI R. , CARBONIN P. 
Published: March 2003

Abstract. Incalzi RA, Fuso L, Serra M, Basso S, Carosella L, Tramaglino LM, Pistelli R, Carbonin P. (Department of Geriatrics and Department of Respiratory Physiology, Catholic University, Rome, Italy). Exacerbated chronic obstructive pulmonary disease: a frequently unrecognized condition. J Intern Med 2002; 252: 48–55. Objectives. To assess to which extent exacerbated chronic obstructive pulmonary disease (COPD) remains unrecognized in the emergency department, which factors account for misdiagnosis and which are the effects of misdiagnosis on patient's management. Design. Retrospective study and stratified random sampling method as selection criterion. Setting. University Hospital. Subjects. Eighty patients representative of those discharged from the wards of medicine with a diagnosis of exacerbated COPD and 72 having a discharge diagnosis of coronary artery disease (CAD) were studied. Main outcome measures. Degree of concordance between admission and discharge diagnosis; presenting symptoms and signs of patients correctly or incorrectly classified on admission; impact of diagnostic procedures carried out by the physician on call on patient's management. Results. The correct diagnosis was missed on admission in 13/80 COPD and 3/72 CAD patients (χ2: 5.87, P=0.015). The prevalence of the following presenting features distinguished the 67 COPD patients who were correctly classified on admission from the remaining 13: severe weakness (21 vs. 10, χ2: 9.53, P=0.002), dyspnea (60 vs. 3, χ2: 28.75, P < 0.001), and limb oedema (14 vs. 6, χ2: 3.70, P=0.054). Critical hypoxemia was diagnosed and treated only after admission in 19 COPD patients. Conclusions Exacerbated COPD frequently escapes recognition in the emergency room, mainly if severe weakness and limb oedema are its presenting features. Arterial blood gas analysis is not systematically performed in the emergency room and, consequently, oxygen therapy is either not administered or given to selected COPD patients on an empirical basis.
What cause of mortality can we predict by cholesterol screening in the Japanese general population?
Authors: Okamura T. , Kadowaki T. , Hayakawa T. , Kita Y. , Okayama A. , Ueshima H. ,   For the Nippon Data80 Research Group
Published: March 2003

Abstract.  Okamura T, Kadowaki T, Hayakawa T, Kita Y, Okayama A, Ueshima H (Shiga University of Medical Science, Shiga, Japan; Iwate Medical University, Morioka, Iwate, Japan). What cause of mortality can we predict by cholesterol screening in the Japanese general population? J Intern Med 2003; 253: 169–180.Objective.  In a population with a markedly lower coronary mortality such as in Japan, the benefit of cholesterol screening may be different from Western populations. We attempted to assess the importance of cholesterol screening in Japan.Design.  A 13.2‐year cohort study for cause‐specific mortality.Setting.  Three hundred randomly selected districts throughout Japan in which the National Survey on Circulatory Disorders 1980 was performed.Subjects.  A total of 9216 community dwelling persons aged 30 years and over, with standardized serum cholesterol measurement and without a past history of cardiovascular disease.Results.  There were 1206 deaths, which included 462 deaths due to cardiovascular disease with 79 coronary heart diseases. Hypercholesterolemia (>6.21 mmol L−1) showed a significant positive relation to coronary mortality (relative risk; 2.93, 95% confidence interval; 1.52–5.63) but not to stroke. Although hypocholesterolemia (<4.14 mmol L−1) was significantly associated with an increased risk of liver cancer, noncardiovascular, noncancer disease and all‐cause mortality, these associations, except for liver cancer, disappeared after excluding deaths in the first 5 years of the follow‐up. The multivariate adjusted attributable risk of hypercholesterolaemia for coronary disease was 0.98 per 1000 person‐years, which was threefold higher than that of hypocholesterolemia for liver cancer: 0.32 per 1000 person‐years. The attributable risk percentage of hypercholesterolaemia was 66% for coronary heart disease.Conclusion.  Similar to Western populations, it is recommended to provide screening for hypercholesterolaemia in Japan, especially for males, although its attributable risk for coronary disease might be small.
Ultrastructure of the frog retina after high‐pressure freezing and freeze substitution
Authors: Wilson  , Farmer  , Karwoski  
Published: March 2003

In many types of tissue, high‐pressure freezing (HPF), followed by freeze substitution, can produce excellent ultrastructural preservation at depths over 10 times that obtained by other cryofixation techniques. However, in the case of neural tissue, the benefits of HPF have not been realized. In the present study, isolated frog (Rana pipiens) retina was sliced at a thickness of 150 or 350 μm, rapidly frozen in a Balzers HPM 010 high‐pressure freezer, and freeze substituted with 1% OsO4 and 0.1% tannic acid in acetone. Specially designed HPF chambers and specific freezing media (35% high‐MW dextran for 150‐μm slices or 15% low‐MW dextran for 350‐μm slices) were required for adequate freezing.The quality of preservation after HPF was excellent throughout the retina in both the 150‐ and 350‐μm slices, compared with chemically fixed slices. Specifically, HPF resulted in better preserved cellular, mitochondrial and nuclear membranes in all retinal layers.This is the first study to successfully cryofix all of the layers of the retina. The increased depths of adequate freezing achieved by HPF should facilitate various ultrastructural studies of retina, as well as of other CNS tissues, where preservation approaching that of the ‘native’ state is required.