bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impaired granulocyte formylpeptide‐induced superoxide generation in chronically ill, malnourished, elderly patients
Authors: Cederholm T. , Gyllenhammar H. 
Published: March 2003

Abstract. Cederholm T, Gyllenhammar H (Huddinge University Hospital, Huddinge, Sweden). Impaired granulocyte formylpeptide‐induced superoxide generation in chronically ill, malnourished, elderly patients. J Intern Med 1999; 245: 475–482.Objective. Protein‐energy malnutrition (PEM), often occurring in patients with chronic disease, is associated with a decreased capacity to combat infections. In this study we assessed polymorphonuclear neutrophil (PMN) superoxide anion (·O2–) formation in elderly PEM patients with various chronic diseases.Design and subjects. Nineteen patients (75 ± 1 years), with body mass index 17.1 ± 0.4, and 19 age‐matched healthy controls were included. Fourteen patients and 14 controls were re‐examined in a 3 month follow‐up.Setting. A service of internal medicine at a university‐affiliated hospital.Interventions. Eight patients were prescribed a dietary liquid supplementation during the observation period.Main outcome measures. Superoxide production in PMN induced by fMLP (a receptor ligand) and phorbol myristate acetate (PMA), which acts directly on protein kinase C.Results. fMLP‐induced superoxide generation in the malnourished patients was 55 ± 5% of that of the controls. However, the patients retained their capacity, 108 ± 6% of control PMN generation, to respond to PMA. In those who received formula supplementation, fMLP‐generated ·O2– production levels were 48 ± 8 and 73 ± 13% (P = 0.12) of those of controls at the start and after 3 months, respectively. Corresponding figures in those who were not prescribed supplementation were 57 ± 8 and 64 ± 4% (P = 0.55).Conclusion. Possibly contributing to reduced host defence, receptor ligand‐induced PMN generation of ·O2– is significantly lower in chronically ill, elderly patients with PEM than in age‐matched healthy controls.
Lean mass and physical activity as predictors of bone mineral density in 16–20‐year old women
Authors: Valdimarsson Ö. , Kristinsson J. Ö. , Stefansson S. Ö. , Valdimarsson S. , Sigurdsson G. 
Published: March 2003

Abstract. Valdimarsson Ö, Kristinsson JÖ, Stefansson SÖ, Valdimarsson S, Sigurdsson G (Reykjavik Hospital, University of Iceland, Reykjavik, Iceland). Lean mass and physical activity as predictors of bone mineral density in 16–20‐year old women. J Intern Med;245: 489–496.Objective.  The aim of the study was to quantify the inter‐relationship between bone mineral density and physical activity, muscle strength, and body mass composition in a group of healthy 16–20‐year‐old women.Design. A cross‐sectional study.Setting.  Reykjavik area.Subjects.  Two‐hundred and fifty‐four Icelandic Caucasian women aged 16, 18 and 20 years, randomly selected from the registry of Reykjavik.Main outcome measures.  Bone mineral content (BMC) and density (BMD) in lumbar spine, hip, distal forearm and total skeleton and lean mass and fat mass were measured with dual energy X‐ray absorptiometry (DEXA) and compared with grip strength measured with a dynamometer and physical activity as assessed by a questionnaire.Results.  The lean mass had the strongest correlation with BMC and BMD, stronger than weight, height and fat mass, both in univariate analysis (r = 0.41–0.77; P < 0.001) and in linear regression analysis. The total skeletal BMD was logarithmically higher by hours of exercise per week (P < 0.001)). About 30% of variability in total skeletal BMD in this age group can be predicted by lean mass and physical exercise.Conclusions.  Modifiable factors, such as exercise and adequate muscle seem to be significant predictors of the attainment of peak bone mass in women.
Oral clodronate in breast cancer patients with bone metastases: a randomized study
Authors: Kristensen B. , Ejlertsen B. , Groenvold M. , Hein S. , Loft H. , Mouridsen H. T. 
Published: March 2003

Objectives. To investigate the effect of the bisphosphonate clodronate on the occurrence of skeletal events (hypercalcaemia, fractures and radiotherapy) in breast cancer patients with bone metastases.Design. Prospective, randomized, controlled, clinical trial.Setting. A department of oncology in a university hospital.Subjects. One hundred patients who received first‐line systemic antineoplastic treatment for metastatic breast cancer with bone involvement were randomized to receive clodronate as two 400 mg capsules twice a day for 2 years or no additional therapy.Results. In the clodronate group the number of skeletal events was reduced to 14 events in 48 evaluable patients as compared with 21 events in 51 evaluable control patients. The time to the first skeletal event was significantly longer in the clodronate group than in the control group (P = 0.015) and the most distinct difference was a lower occurrence of fractures in the clodronate group (P = 0.023). After 15 months the effect of clodronate tended to decline as the need for radiotherapy increased in the clodronate group compared with the control group (P = 0.069). Significant improvements in several quality‐of‐life aspects were seen in both groups during the first 6 months, but there was no significant difference between the groups. No effect was observed on time to radiologically evaluated disease progression in bone or on survival. The most frequent side‐effects resulting in discontinuation of clodronate were nausea and diarrhoea.Conclusion. Oral clodronate is associated with a temporary reduction of morbidity related to bone metastases in breast cancer patients.
Insulin sensitivity and haemostatic factors in men at high and low cardiovascular risk
Authors: Agewall S. 
Published: March 2003

Abstract. Agewall S (Sahlgrenska University Hospital, Göteborg University, Sweden). Insulin sensitivity and haemostatic factors in men at high and low cardiovascular risk. J Intern Med 1999; 246: 489–495.Objective. To investigate the relationship between variables of the coagulation and fibrinolysis system and insulin sensitivity in non‐diabetic men at high and low risk of cardiovascular disease.Design. Cross‐sectional study.Setting. Outpatient clinic in city hospital.Patients. Thirty‐five men at high risk for atherosclerotic disease (hypertension and at least one the following factors: hypercholesterolaemia and smoking) and an age‐matched low‐risk group (n = 23) with no cardiovascular risk factors.Main outcome measures. Insulin‐mediated glucose disposal (hyperinsulinaemic euglycaemic clamp) adjusted for lean body mass and fibrinogen, von Willebrand factor, prothrombin fragment 1 + 2, thrombin/antithrombin complex and plasminogen activator inhibitor activity were determined.Results. Insulin‐mediated glucose disposal adjusted for lean body mass was significantly lower in the high‐risk group than in the low‐risk group. Glucose disposal was significantly negatively associated with plasminogen activator inhibitor activity (PAI) in the high‐risk group and with von Willebrand factor in the low‐risk group. In the whole study group, fibrinogen and PAI were significantly associated with glucose disposal. After adjusting for confounding factors, glucose disposal was independently negatively associated with PAI in the high‐risk group (P < 0.001) and in the whole group (P < 0.001).Conclusions. High‐risk men were significantly more insulin‐resistant than the low‐risk group. Glucose disposal adjusted for lean body mass was associated with an impaired fibrinolytic activity in the high‐risk group. Fibrinogen was associated with insulin resistance in the whole study group. The negative relationship between von Willebrand factor levels and glucose disposal in the low‐risk group may indicate that insulin resistance can induce an endothelial dysfunction even in non‐diabetic subjects.
Clinical assessment of suspected deep vein thrombosis: comparison between a score and empirical assessment
Authors: Miron M.‐J. , Perrier A. , Bounameaux H. 
Published: March 2003

Abstract. Miron M‐J, Perrier A, Bounameaux H (Division of Angiology and Hemostasis, and Medical Clinic 1, Department of Internal Medicine, Geneva University Hospital, Geneva, Switzerland). Clinical assessment of suspected deep vein thrombosis: comparison between a score and empirical assessment. J Intern Med 2000; 247: 249–254.Objectives. To assess the accuracy and agreement of two methods of clinical evaluation: a formal score based on a number of items of fixed value (the so‐called Wells’ score), and an empirical assessment based on a predefined list of items that can be weighted individually. Clinical probability is essential to manage suspected deep vein thrombosis (DVT) and should be assessed before any diagnostic test.Design. An open, nonrandomised, one‐centre study.Setting. One centre in Switzerland (a university hospital delivering primary‐tertiary care).Subjects. Two hundred and seventy outpatients with a prevalence of DVT of 21.1% (final diagnosis), out of an initial population of 328 patients, of which 52 had to be excluded because of a history of DVT (score not applicable) or because of insufficient clinical information (n = 6).Results. Agreement between the two assessment tools was poor (kappa value of 0.32), but accuracy was excellent, with a prevalence of DVT of 1.3%, 18.1%, and 100% (empirical assessment), and 3.2%, 19.4%, and 73.9% (Wells’ score), for a low, intermediate or high clinical probability estimate, respectively. The main differences between the two methods were that (i) the empirical method performed slightly better in categorizing patients in the high probability class, and (ii) Wells’ score categorized more patients in the low probability class. When applied to two validated diagnostic strategies, the empirical assessment required slightly fewer phlebograms in both strategies, and Wells’ score required fewer repeat ultrasonograms (in the strategy that requires this procedure).Conclusions. Clinical probability assessment can be done with a similar accuracy either empirically or using a score. Institutions should incorporate clinical probability assessment with either method depending upon their diagnostic strategy for suspected DVT.
Independent effects of obesity and cortisol in predicting cardiovascular risk factors in men and women
Authors: Walker B. R. , Soderberg S. , Lindahl B. , Olsson T. 
Published: March 2003

Abstract. Walker BR, Soderberg S, Lindahl B, Olsson T (University of Edinburgh, Western General Hospital, Edinburgh, UK and the University of Umea, University Hospital, Umea, Sweden). Independent effects of obesity and cortisol in predicting cardiovascular risk factors in men and women. J Intern Med 2000; 247: 198–204.Objectives. Recent data suggest that higher plasma cortisol may be associated with hypertension and insulin resistance in otherwise healthy men, as it is in Cushing’s syndrome. However, obesity in women is associated with lower plasma cortisol concentrations. This study sought to establish whether plasma cortisol is associated with cardiovascular risk factors in women as it is in men, and whether these relationships in either sex are confounded by obesity.Design. A population‐based cross‐sectional study.Setting. The MONICA study in northern Sweden.Subjects. From a target cohort of 2500, 1921 subjects took part and 226 were randomly selected because they attended between 07.00 and 09.00 h after an overnight fast. A 75 g oral glucose tolerance test was performed and blood sampled at baseline and 2 h after glucose.Results. Plasma cortisol was lower in relatively obese subjects: in men, this was observed only in the 2 h sample (r = –0.23, P = 0.02) and in women only in the fasting sample (r = –0.26, P < 0.01). Simple regression analysis did not identify relationships between plasma cortisol and blood pressure, serum lipids, fasting insulin or glucose tolerance. However, after adjusting for the effect of obesity by multiple regression, higher plasma cortisol was independently associated with higher diastolic blood pressure in men (r = 0.21, P = 0.04) but not in women, and higher fasting serum triglyceride levels in women (r = 0.28, P < 0.001) but not in men.Conclusions. Increasing obesity and plasma cortisol concentrations make independent and sex‐specific contributions to variations in blood pressure and aspects of the insulin resistance syndrome. Adverse cardiovascular risk is greatest in those with the combination of obesity and failure to downregulate plasma cortisol levels.
Advanced glycation end product in familial amyloidotic polyneuropathy (FAP)
Authors: Nyhlin N. , Ando Y. , Nagai R. , Suhr O. , El Sahly M. , Terazaki H. , Yamashita T. , Ando M. , Horiuchi S. 
Published: March 2003

Abstract. Nyhlin N, Ando Y, Nagai R, Suhr O, El Sahly M, Terazaki H, Yamashita T, Ando M, Horiuchi S (Umeå University Hospital, Umeå, Sweden and Kumamoto University School of Medicine, Kumamoto, Japan). Advanced glycation end product in familial amyloidotic polyneuropathy (FAP). J Intern Med 2000; 247: 485–492.Objectives. Advanced glycation end products (AGE) are present in amyloid deposits in β2‐microglobulin amyloidosis, and it has been postulated that glycation of β2‐microglobulin may be involved in fibril formation. The aim of this paper was to ascertain whether AGE occur in amyloid deposits in familial amyloidotic polyneuropathy (FAP).Setting. Department of Medicine, Umeå University Hospital and First Department of Internal Medicine, Kumamoto University School of Medicine.Design. The presence of AGE was sought immunohistochemically and biochemically in amyloid‐rich tissues from patients with FAP.Subjects. Biopsy specimens from nine patients and 10 controls were used for the immunohistochemical analysis. For amyloid preparation, vitreous samples from three FAP patients were used.Results. Immunohistochemical studies using a polyclonal anti‐AGE antibody revealed positive immunoreactivity in intestinal materials, but the pattern of reactivity was unevenly distributed; it was often present in the border of amyloid deposits, or surrounding them. Non‐amyloid associated immunoreactivity was also observed in a few regions of the specimens, although the AGE‐positive structures were situated in areas containing amyloid deposits. Western blotting of purified amyloid from the vitreous body of FAP patients revealed a significant association of AGE with amyloid fibrils.Conclusion. The immunoreactivity for the AGE antibody suggests that AGE may be involved in fibril formation in FAP.
The common pentanucleotide polymorphism of the 3′‐untranslated region of the leptin receptor gene is associated with serum insulin levels and the risk of type 2 diabetes in non‐diabetic men: a prospective case–control study
Authors: Lakka H.‐M. , Oksanen L. , Tuomainen T.‐P. , Kontula K. , Salonen J. T. 
Published: March 2003

Abstract. Lakka H‐M, Oksanen L, Tuomainen T‐P, Kontula K, Salonen JT (University of Kuopio, Kuopio, and the University of Helsinki, Helsinki, Finland). The common pentanucleotide polymorphism of the 3′‐untranslated region of the leptin receptor gene is associated with serum insulin levels and the risk of type 2 diabetes in non‐diabetic men: a prospective case–control study. J Intern Med 2000; 248: 77–83.Objectives. The purpose of the study was to test whether the pentanucleotide insertion/deletion polymorphism in the 3′‐untranslated region (3′‐UTR) of the leptin receptor gene, which has previously been associated with serum insulin levels in obese subjects, is associated with insulin levels and the risk of type 2 diabetes in non‐diabetic middle‐aged men.Subjects and design. We studied these associations in a prospective population‐based nested case–control study in 41 men who developed type 2 diabetes during 4‐year follow‐up and 81 controls who were matched for age, obesity, baseline glucose and insulin and other strongest risk factors. Both the cases and the controls came from a cohort of 985 men who had no diabetes at baseline.Results. There was one homozygote and 22 heterozygotes for the 3′‐UTR insertion allele amongst all 122 men. The carrier frequency of this allele was 9.8% amongst the cases and 23.5% amongst the controls. At baseline, the mean fasting serum insulin was 12.2 mU L–1 in the 23 men who were heterozygous or homozygous for the insertion allele and 17.1 mU L–1 in the 99 men who were homozygous for the deletion allele (P = 0.005). In a logistic regression model adjusting for four strongest non‐matched predictors of type 2 diabetes, the carriers of the insertion allele had a 79% reduced risk of diabetes (OR = 0.21; 95% CI = 0.06–0.77, P = 0.019), compared with non‐carriers.Conclusion. Our findings support the hypothesis that alterations in the leptin signalling system could contribute to serum insulin levels and the development of type 2 diabetes.
Postmenopausal hormone therapy: less favourable risk–benefit ratios in healthy Dutch women
Authors: Moerman C. J. , Van Hout B. A. , Bonneux L. , Witteman J. C. M. 
Published: March 2003

Abstract. Moerman CJ, van Hout BA, Bonneux L, Witteman JCM (University of Amsterdam, Amsterdam, and Erasmus University Medical School, Rotterdam, the Netherlands). Postmenopausal hormone therapy: less favourable risk–benefit ratios in healthy Dutch women. J Intern Med 2000; 248: 143–150.Objectives. To estimate the health effects of postmenopausal hormone therapy used for 10 or 20 years in a population of intermediate cardiovascular risk.Design. Using existing estimates of the effect of hormone therapy on rates of myocardial infarction, hip fracture and breast cancer, a proportional multistage life table was generated to calculate the effects of use for 10 and 20 years in a synthetic cohort of Dutch women aged 55 with an average and a high‐risk profile for cardiovascular disease.Results. A woman of the general population who starts hormone therapy at age 55 for 10 years can prolong her life by 1 month and may postpone the occurrence of first incidence of one of the diseases under consideration by 2.4 months. One excess breast cancer case is likely to occur per 5–6 averted cases of first myocardial infarction or hip fracture. If she prolongs her use to 20 years, the gain of life expectancy and disease‐free life expectancy is doubled. The risk–benefit ratio worsens to one extra breast cancer per 3–4 averted cases of the preventable diseases. For a woman with a high‐risk profile, the gains in health are about twice as high as for her counterpart in the general population, and her risk–benefit ratio is also more favourable. Yet, the risk–benefit ratio still worsens for 20 as compared with 10 years of use.Conclusions. Women from the general population in the Netherlands and similar populations can achieve only a modest gain in life expectancy by using hormones during 10 or 20 years following menopause. This is a consequence of the low incidence of myocardial infarction and hip fracture and the relatively high incidence of breast cancer before the age of 75. Women at increased cardiovascular risk can benefit more from hormone therapy. But even amongst these women, the risk of breast cancer incurred with long‐term use offsets much of the benefit that could accrue from changing the risk of heart disease and hip fracture.
Prevalence of pulmonary arteriovenous malformations (PAVMs) and occurrence of neurological symptoms in patients with hereditary haemorrhagic telangiectasia (HHT)
Authors: Kjeldsen A. D. , Oxhøj H. , Andersen P. E. , Green A. , Vase P. 
Published: March 2003

Abstract. Kjeldsen AD, Oxhøj H, Andersen PE, Green A, Vase P (Odense University and Odense University Hospital, Odense; University of Aarhus, Aarhus; and the Department of Otorhinolaryngology, Svendborg, Denmark). Prevalence of pulmonary arteriovenous malformations (PAVMs) and occurrence of neurological symptoms in patients with hereditary haemorrhagic telangiectasia (HHT). J Intern Med 2000; 248: 255–262.Background. Hereditary haemorrhagic telangiectasia (HHT) is a dominantly inherited disease. HHT is characterized by a wide variety of clinical manifestations, including pulmonary arteriovenous malformations (PAVMs) and neurological symptoms.Objective. To estimate (i) the prevalence of PAVM, and (ii) the occurrence of neurological symptoms in a geographical well‐defined population of HHT patients.Methods. HHT family members were invited to a clinical examination including registration of HHT manifestations, screening for pulmonary arteriovenous malformations and neurological evaluation. Two groups served as controls: (i) first‐degree relatives without any signs of HHT; and (ii) age‐ and gender‐matched controls.Setting. Odense University Hospital.Subjects. HHT patients identified in a cross‐sectional family survey carried out in the County of Fyn, Denmark.Results. Included in the study were 169 HHT family members representing 24 families. They included both HHT patients and their first‐degree relatives. The criteria of HHT were fulfilled in 75 participants; of these, 59 had a screening procedure performed, and PAVMs were demonstrated at pulmonary angiography (PA) in 18. Seven of the HHT patients had a history of cerebral stroke, compared with none of their healthy first‐degree relatives.Conclusion. The prevalence of PAVM was 24% amongst HHT patients. The study confirmed an increased prevalence of neurological symptoms amongst HHT patients; the odds ratio was estimated to be 7.6. In order to enable prevention of these complications, screening for PAVM should become an integral part of the medical care for HHT patients.
Toxin‐mediated haemolytic uraemic syndrome without diarrhoea
Authors: Kater A. P. , Westermann A. M. , De Groot M. R. , Von Dem Borne A. E. G. KR. , Kuijper E. J. 
Published: March 2003

Abstract. Kater AP, Westermann AM, de Groot MR, von dem Borne AEGKr (Academic Medical Centre, Amsterdam, The Netherlands). Toxin‐mediated haemolytic uraemic syndrome without diarrhoea (Case Report). J Intern Med 2000; 248: 263–265.A 52‐year‐old previously healthy man was admitted to the hospital with haematuria, painful micturition and fever. Laboratory investigation showed the presence of a haemolytic uraemic syndrome (HUS), characterized by haemolysis, renal insufficiency and mental disturbances. A urinary tract infection caused by a verotoxin‐producing E. coli other than O157:H7 was diagnosed. Treatment of this infection resulted in his complete recovery from the illness. Both the search for a focus outside the gastrointestinal tract and the search for verotoxin genes by specific polymerase chain reaction can be crucial in a patient with HUS without preceding diarrhoea.