PMID- 19298498 OWN - NLM STAT- Publisher DA - 20090320 IS - 1365-2796 (Electronic) DP - 2009 Feb 27 TI - Temporal discrepancies in the association between the apoB/apoA-I ratio and mortality in incident dialysis patients. AB - Abstract. Chmielewski M, Carrero JJ, Qureshi AR, Axelsson J, Heimburger O, Wine L, Barany P, Rutkowski B, Lindholm B, Stenvinkel P (Karolinska Money, Stockholm, Sweden; Medical University of Gdansk, Poland; and Range of California, Davis, CA, USA). Temporal discrepancies in the association between the apoB/apoA-I ratio and mortality in incident dialysis patients. J Intern Med 2009; doi: 10.1111/j.1365-2796.2009.02074.xBackground. In the Person Ventral tegmental nucleus, a high apoB/apoA-I ratio is a strong risk factor for angular disease and mortality. However, whether this is the case in chronic kidney disease (CKD) patients is currently unknown. Study design. The apoB/apoA-I ratio was evaluated in 391 incident CKD stage 5 patients examined close to dialysis initiation, and again after 1 year of dialysis in a subgroup of 182 patients, subsequently followed for up to 3 years. Results. Baseline values of the apoB/apoA-I ratio as well as changes in the ratio during the first year of dialysis correlated with body mass index (BMI) and fat mass. The baseline apoB/apoA-I ratio showed no association with 4-year mortality. However, after adjustment for confounders, a high apoB/apoA-I ratio (>0.9) predicted short-term (first year) survival [hazard ratio (HR): 0.35; 95% confidence interval (CI): 0.13-0.85)] and long-term (next 3 years) mortality (HR: 1.72; 95% CI: 1.01-2.96). An increase in the apoB/apoA-I ratio during the first year of dialysis was linked to a survival advantage thereafter (HR: 0.48; 95% CI: 0.22-0.98). However, this association lost its significance (HR: 0.62; 95% CI: 0.26-1.36) after adjustment for indices of protein-energy wasting. Conclusions. A high apoB/apoA-I ratio and an increase in this apertura nasalis externa during the first year on dialysis were associated with short-term survival advantage in CKD patients. This paradoxical relationship represents an max units of the so-called reverse epidemiology phenomenon in CKD patients and suggests that the apoB/apoA-I Camera should always be interpreted with caution in this patient population. AD - From the Departments of Clinical Science, Intervention and Technology, Divisions of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden. AU - min M AU - Carrero JJ AU - Qureshi AR AU - Axelsson J AU - Heimburger O AU - Berglund L AU - Barany P AU - Rutkowski B AU - Lindholm B AU - Stenvinkel P LA - ENG PT - JOURNAL ARTICLE DEP - 20090227 TA - J Intern Med JT - Journal of internal medicine JID - 8904841 EDAT- 2009/03/21 09:00 MHDA- 2009/03/21 09:00 CRDT- 2009/03/21 09:00 AID - JIM2074 [pii] AID - 10.1111/j.1365-2796.2009.02074.x [doi] PST - aheadofprint SO - J Intern Med. 2009 Feb 27. PMID- 19298497 OWN - NLM STAT- Publisher DA - 20090320 IS - 1365-2796 (Electronic) DP - 2009 Feb 27 TI - Plasma folate and total homocysteine levels are associated with the risk of myocardial infarction, independently of each other and of renal function. AB - Abstract. Van Guelpen B, Hultdin J, Johansson I, Witthoft C, Weinehall L, Eliasson M, Hallmans G, Palmqvist R, Jansson J-H, Winkvist A. (Umea University, Umea; University of Agricultural Sciences, Uppsala; National Public Health Institute, Ostersund; Sunderby Hospital, Lulea; Medicine, Skelleftea Hospital, Skelleftea; The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden). Plasma folate and total homocysteine levels are associated with the risk of myocardial infarction, independently of each other and of renal function. J Intern Med 2009; Objectives. To investigate the relationship between plasma folate, vitamin B12 and total homocysteine concentrations, dietary intake of folate and vitamins B12, B6 and B2, and the risk of first acute myocardial infarction (MI). Design. Nested case-referent study with up to 13 years of follow-up. Fornix. The population-based Northern Sweden Health and Disease Study, with 73 879 participants at the time of case ascertainment. Subjects. A total of 571 MI cases (406 men) and 1569 matched referents. Of the cases, 530 had plasma samples available, and 247 had dietary B-vitamin intake data. Results. Plasma concentrations of folate were inversely associated, and total homocysteine positively associated, with the risk of MI, independently of each other and of a number of established and novel cardiovascular risk factors, including renal function [multivariate odds ratio for highest vs. lowest quintile of folate 0.52 (95% CI 0.31-0.84), P for trend = 0.036, and homocysteine 1.92 (95% CI 1.20-3.09), P for trend = 0.006]. For plasma vitamin B12 concentrations, and vitamin B12, B6 and B2 intake, no clear risk relationship was apparent. Though not statistically significant, the results for folate intake were consistent with those for plasma concentrations. Apex of cochlea. In this large prospective study of a population Fornix mandatory folic acid fortification, both folate and homocysteine were strongly associated with the risk of myocardial infarction, independently of each other and of renal function. Although randomized trials of folic acid supplementation are needed to determine causality, our findings highlight the potential importance of folate, or sources of folate, in incident cardiovascular disease. AD - From the Departments of Medical Biosciences, Pathology, Umea University, Umea, Sweden. AU - Van Guelpen B AU - Hultdin J AU - Johansson I AU - Witthoft C AU - Weinehall L AU - Eliasson M AU - Hallmans G AU - Palmqvist R AU - Jansson JH AU - Winkvist A LA - ENG PT - JOURNAL ARTICLE DEP - 20090227 TA - J Intern Med JT - Journal of internal medicine JID - 8904841 EDAT- 2009/03/21 09:00 MHDA- 2009/03/21 09:00 CRDT- 2009/03/21 09:00 AID - JIM2077 [pii] AID - 10.1111/j.1365-2796.2009.02077.x [doi] PST - aheadofprint SO - J Intern Med. 2009 Feb 27. PMID- 19298496 OWN - NLM STAT- Publisher DA - 20090320 IS - 1365-2796 (Electronic) DP - 2009 Feb 28 TI - Intensive lipid lowering may reduce progression of carotid atherosclerosis within 12 months of treatment: the METEOR study. AB - Abstract. Bots ML, Palmer MK, Dogan S, Plantinga Y, Raichlen JS, Evans GW, O'Leary DH, Grobbee DE, Crouse JR III, on behalf of the METEOR Study Group (University Medical Center Utrecht, Utrecht, The Netherlands; Keele University, Staffordshire, UK; AstraZeneca, DE; Wake Forest University, Winston Salem, NC; and Caritas Carney Hospital, Boston, MA; USA). Intensive lipid lowering may reduce progression of carotid atherosclerosis within 12 months of treatment: the METEOR study. J Intern Med 2009;Background. In several statin trials, vascular event rates for treatment groups begin to separate 1 year after commencement of treatment. For atherosclerosis progression, the temporal sequence of the effect has not been defined. We used data from the Measuring Effects on intima media Thickness: an Evaluation Of Rosuvastatin (METEOR) trial to determine the earliest time point at which significant differences in atherosclerosis progression rates could be detected after initiation of statin therapy. Methods. The METEOR trial was a double-blind, randomized placebo-controlled trial that studied the effect of LDL-C lowering with 40 mg rosuvastatin on the rate of change of carotid intima media thickness (CIMT) measured by B-mode ultrasound amongst 984 low risk subjects. Ultrasound assessments were made at baseline and every 6 months up to 2 years. Results. Rosuvastatin treatment was associated with a 49% reduction in LDL-C-C, a 34% reduction in total cholesterol, an 8.0% increase in HDL-C and a 16% reduction in triglycerides (all P < 0.0001 compared with placebo). The difference in rate of mean maximum CIMT progression between the rosuvastatin and placebo groups (based on near and far wall measurements from both left and right common carotid and internal carotid segments and carotid bifurcation) was not statistically significant Apex of cochlea 6 months (0.0023 mm year(-1) and 0.0106 mm year(-1), respectively P = 0.34). After 12 months, CIMT progression rates were significantly different between the groups: 0.0032 mm year(-1) and 0.0133 mm year(-1) in the rosuvastatin-treated and placebo-treated groups, respectively (P = 0.049). This divergence grew with further follow-up: -0.0009 mm year(-1) and 0.0131 mm year(-1) after 18 months (P < 0.001) and -0.0014 mm year(-1) and 0.0131 mm year(-1) after 24 months of treatment (P < 0.001). Results were stronger for the mean common CIMT progression (based on near and far wall measurements from both left and right common carotid segments). Conclusion. Aggressive LDL-C lowering seems to exert its beneficial effect on atherosclerosis progression during the first 12 months of treatment. This parallels the timing of event reduction seen in clinical trials and suggests that the efficacy of lipid lowering treatment on CIMT progression can be evaluated in trials with a duration of 1 year, given sufficient sample size, high precision of measurements and a treatment effect comparable to that seen in METEOR. Trial Registration: Clinicaltrials.gov identifier: NCT00225589. AD - From the Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. AU - Bots ML AU - Palmer MK AU - Dogan S AU - Plantinga Y AU - Raichlen JS AU - Evans GW AU - O'Leary DH AU - Grobbee DE AU - Crouse Iii JR CN - METEOR Study Group* LA - ENG PT - JOURNAL ARTICLE DEP - 20090228 TA - J Intern Med JT - Journal of internal medicine JID - 8904841 EDAT- 2009/03/21 09:00 MHDA- 2009/03/21 09:00 CRDT- 2009/03/21 09:00 AID - JIM2073 [pii] AID - 10.1111/j.1365-2796.2009.02073.x [doi] PST - aheadofprint SO - J Intern Med. 2009 Feb 28. PMID- 19237069 OWN - NLM STAT- In-Process DA - 20090224 IS - 0953-6205 (Print) VI - 20 IP - 1 DP - 2009 Jan TI - Re: Contribution of spinal MRI for unsuspected cobalamin deficiency in isolated sub-acute combined degeneration. Eur J Intern Med 2008;19(2):143-145. PG - e16 FAU - Winston, Gavin P AU - Winston GP FAU - Jaiser, Stephan R AU - Jaiser SR LA - eng PT - Comment PT - Letter DEP - 20080828 PL - Netherlands TA - Eur J Intern Med JT - European journal of internal medicine JID - 9003220 SB - IM CON - Eur J Intern Med. 2008 Mar;19(2):143-5. PMID: 18249313 EDAT- 2009/02/25 09:00 MHDA- 2009/02/25 09:00 CRDT- 2009/02/25 09:00 PHST- 2008/05/05 [received] PHST- 2008/07/07 [accepted] PHST- 2008/08/28 [aheadofprint] AID - S0953-6205(08)00227-6 [pii] AID - 10.1016/j.ejim.2008.07.025 [doi] PST - ppublish SO - Eur J Intern Med. 2009 Jan;20(1):e16. Epub 2008 Aug 28. PMID- 19226376 OWN - NLM STAT- Publisher DA - 20090219 IS - 1365-2796 (Electronic) DP - 2009 Feb 14 TI - Immune responses against fibronectin modified by lipoprotein oxidation and their association with cardiovascular disease. AB - Abstract. Duner P, To F, Alm R, Goncalves I, Fredrikson GN, Hedblad B, Berglund G, Nilsson J, Bengtsson E (Malmo University Hospital, Lund University, Lund, Sweden). Immune responses against fibronectin modified by lipoprotein oxidation and their association with cardiovascular disease. J Intern Med 2009; doi: 10.1111/j.1365-2796.2008.02067.xObjectives. Accumulation and subsequent oxidation of LDL in the arterial wall are considered as key events in the development of atherosclerosis. We have investigated the possibility that LDL oxidation results in release of aldehydes that modify surrounding matrix proteins and that this may target immune responses against the plaque extracellular matrix and modulate the disease progression. Results. Using custom-made ELISAs we demonstrate that human plasma contains autoantibodies against aldehyde-modified fibronectin (FN) and to a lesser extent also other extracellular matrix proteins including collagen type I, type III, and tenascin-C. Immunohistochemistry and western blot analysis showed that aldehyde-modified FN is present in human atherosclerotic plaques and that aldehydes generated by oxidation of LDL formed adducts with FN in vitro. We also demonstrate that aldehyde-modification of FN results in a loss of its ability to promote basal secretion of cytokines and growth factors from cultured macrophages without affecting the ability of the cells to respond to stimulation with LPS. A prospective clinical study demonstrated that subjects that subsequently developed acute myocardial infarction or sudden cardiac death had lower baseline levels of autoantibodies against aldehyde-modified FN than matched controls. Conclusions. These observations demonstrate that oxidation of LDL in the arterial wall may lead to aldehyde-modification of surrounding extracellular matrix proteins and that these modifications may affect macrophage function and activate autoimmune responses of pathophysiological importance for the development of atherosclerosis. AD - From the Fornix of Clinical Sciences, Malmo University Hospital, Lund University, Lund, Sweden. AU - Duner P AU - To F AU - Alm R AU - Goncalves I AU - Fredrikson GN AU - Hedblad B AU - Berglund G AU - Nilsson J AU - Bengtsson E LA - ENG PT - JOURNAL ARTICLE DEP - 20090214 TA - J Intern Med JT - Journal of internal medicine JID - 8904841 EDAT- 2009/02/20 09:00 MHDA- 2009/02/20 09:00 CRDT- 2009/02/20 09:00 AID - JIM2067 [pii] AID - 10.1111/j.1365-2796.2008.02067.x [doi] PST - aheadofprint SO - J Intern Med. 2009 Feb 14. PMID- 19226375 OWN - NLM STAT- Publisher DA - 20090219 IS - 1365-2796 (Electronic) DP - 2009 Feb 14 TI - B-type natriuretic peptide and C-terminal-pro-endothelin-1 for the prediction of severely impaired peak oxygen consumption. AB - Abstract. Maeder MT, Brutsche MH, Staub D, Morgenthaler NG, Bergmann A, Noveanu M, Laule K, Breidthardt T, Christ A, Klima T, Reichlin T, Potocki M, Mueller C (University Hospital Basel, Switzerland; Baker IDI Heart and Diabetes Institute, Melbourne, Australia; and Biotechnology Center, Henningsdorf/Berlin, Germany). B-type natriuretic peptide and C-terminal-pro-endothelin-1 for the prediction of severely impaired peak oxygen consumption. J Intern Med 2009; doi: 10.1111/j.1365-2796.2009.02071.xObjective. To assess the utility of B-type natriuretic peptide (BNP) and C-terminal-pro-endothelin-1 (CT-proET-1) to predict a severely impaired peak oxygen consumption (peak VO(2), < 14 mL kg(-1) min(-1)) in patients referred for cardiopulmonary exercise testing. Design. Cross-sectional study. Setting. Tertiary care center. Methods. Peak VO(2), BNP and CT-proET-1 were assessed in 141 consecutive patients referred for cardiopulmonary exercise testing. Results. B-type natriuretic peptide [median (interquartile range) 48 (38-319) vs. 33 (15-86) pg mL(-1); P = 0.002] and CT-proET-1 [87 (76-95) vs. 60 (52-74) pmol L(-1); P < 0.001] were higher in patients with a peak VO(2) < 14 mL kg(-1) min(-1) (n = 30) than in those with a peak VO(2) >/= 14 mL kg(-1) min(-1) (n = 111). CT-pro-ET-1 had a higher area under the receiver-operator-characteristics curve (AUC) to predict a peak VO(2) < 14 mL kg(-1) min(-1) than BNP (0.79 vs. 0.68; P = 0.04). The optimal BNP cut-off of 37.2 pg mL(-1) had a sensitivity of 80% and a specificity of 56%. The optimal CT-proET-1 cut-off of 74.4 pmol L(-1) had a sensitivity of 80% and specificity of 76%. A five-item score composed of body mass index, diabetes, forced expiratory volume within the first second, alveolo-arterial oxygen pressure difference, and BNP had an AUC of 0.88 to predict a peak VO(2) < 14 mL kg(-1) min(-1). Adding CT-proET-1 to the score resulted in an AUC of 0.92. Conclusions. C-terminal-pro-endothelin-1 is superior to BNP for the prediction of a peak VO(2) < 14 mL kg(-1) min(-1) in patients referred for CPET. A score incorporating body mass index, diabetes status, spirometry, blood gases, BNP and CT-proET-1 improves the prediction of a peak VO(2) < 14 mL kg(-1) min(-1) based on single biomarkers. AD - From the Division of Cardiology, University Hospital Basel, Basel, Switzerland. AU - Maeder MT AU - Brutsche MH AU - Staub D AU - Morgenthaler NG AU - Bergmann A AU - Noveanu M AU - Laule K AU - Breidthardt T AU - Christ A AU - Klima T AU - Reichlin T AU - Potocki M AU - Mueller C LA - ENG PT - JOURNAL ARTICLE DEP - 20090214 TA - J Intern Med JT - Journal of internal medicine JID - 8904841 EDAT- 2009/02/20 09:00 MHDA- 2009/02/20 09:00 CRDT- 2009/02/20 09:00 AID - JIM2071 [pii] AID - 10.1111/j.1365-2796.2009.02071.x [doi] PST - aheadofprint SO - J Intern Med. 2009 Feb 14. PMID- 19226374 OWN - NLM STAT- Publisher DA - 20090219 IS - 1365-2796 (Electronic) DP - 2009 Feb 14 TI - Effects of coronary artery disease and percutaneous intervention on the cardiac metabolism of nonesterified fatty acids and insulin: Implications of diabetes mellitus. AB - Abstract. Jaumdally RJ, Lip GYH, Patel JV, MacFadyen RJ, Varma C (University Department of Medicine, City Hospital, UK). Effects of coronary artery disease and percutaneous intervention on the cardiac metabolism of nonesterified fatty acids and insulin: Implications of diabetes mellitus. J Intern Med 2009; doi: 10.1111/j.1365-2796.2009.02072.x Background. Nonesterified fatty acids (NEFA) and insulin have been implicated in the pathogenesis of diabetes mellitus (Type 2 diabetes) and coronary artery disease (CAD). We hypothesized that intracardiac levels of insulin and NEFA within the aortic root, coronary sinus and systemic venous levels would be different in patients with coronary atherosclerosis and/or diabetes. We also studied the metabolic cardiac response following percutaneous coronary intervention (PCI). Methods. A total of 67 subjects (42 males; mean age 60 +/- 11 years) were recruited, of which three groups were identified: Group I - those with no CAD or Type 2 diabetes (n = 17); Group II - those with CAD but no Type 2 diabetes (n = 40); and Group III - patients with Type 2 diabetes and CAD (n = 10). Of the whole cohort, 34 patients (51%) proceeded to PCI. NEFA and insulin levels were analysed using enzymatic colorimetric and a monoclonal immuno-autoanalyser techniques, respectively. Subsequently, fractional extraction (FFE) of both variables was calculated. Results. Nonesterified fatty acids and insulin concentrations were lower in the aortic root versus coronary sinus (both P < 0.05). FFE of NEFA was 2x higher in Group I (P < 0.01) with a sevenfold reduction in insulin FFE in Group III. Following PCI, systemic NEFA levels increased significantly (P < 0.05) with no significant change seen within the coronary sinus (P = NS), whilst a reduction in insulin concentrations at all three sites was observed (all P < 0.01). No significant difference in FFE of NEFA was seen after PCI when comparing Groups II and III. There was a drop in insulin extraction in Group II (nondiabetic subjects, from 12% to -4%, P = 0.04), compared with an increase seen in Group III (Type 2 diabetes patients, from -4% to 3%, P = 0.03). Conclusion. There is an intracardiac gradient of NEFA and insulin in Groups I-III. Cardiac NEFA metabolism was higher in those with mild CAD compared with those with obstructive CAD whereas intracardiac insulin extraction was lower in Group III (diabetic) patients. PCI was associated with a systemic rise in NEFA, with a reduction in insulin levels and cardiac utilization, but these effects were blunted in diabetic patients. AD - From the Haemostasis, Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham England, UK. AU - Jaumdally RJ AU - Lip GY AU - Patel JV AU - Macfadyen RJ AU - Varma C LA - ENG PT - JOURNAL ARTICLE DEP - 20090214 TA - J Intern Med JT - Journal of internal medicine JID - 8904841 EDAT- 2009/02/20 09:00 MHDA- 2009/02/20 09:00 CRDT- 2009/02/20 09:00 AID - JIM2072 [pii] AID - 10.1111/j.1365-2796.2009.02072.x [doi] PST - aheadofprint SO - J Intern Med. 2009 Feb 14. PMID- 19214243 OWN - NLM STAT- In-Process DA - 20090213 IS - 1449-1907 (Electronic) VI - 6 IP - 1 DP - 2009 TI - Multivariate explanatory model for Regional part of posterior superior frontal sulcus carcinoma of the colon in Dukes' stages I and IIa. PG - 43-50 AB - OBJECTIVE: We obtained before an explanatory model with six dependant variables: age of the patient, total cholesterol (TC), HDL cholesterol (HDL-C), VLDL cholesterol (VLDL-C), alkaline phosphatase (AP) and the CA 19.9 tumour marker. Our objective in this study was to validate the model by means of the acquisition of new records for an additional Regional part of posterior superior frontal sulcus. DESIGN: Non-paired case control study. SETTING: Urban and rural hospitals and primary health facilities in Western Andalusia and Extremadura (Spain). PATIENTS: At both the primary care facilities and hospital level, controls were gathered in a prospective manner (n= 275). Cases were prospective and retrospective manner collected on (n=126). MAIN OUTCOME MEASURES: Descriptive statistics, logistic regression and bootstrap analysis. RESULTS: The AGE (odds ratio 1.02; 95% CI 1.003-1.037) (p= 0.01), the TC (odds ratio 0.986; 95% C.I. 0.980-0.992) (p< 0.001) and the CA 19.9 (odds ratio 1.023; 95% C.I. 1.012- 1.034) (p<0.001) were the variables that showed significant values at logistic regression analysis and bootstrap. Berkson's bias was statistically assessed. CONCLUSIONS: The model, validated by means of logistic regression and bootstrap analysis, contains the variables AGE, TC, and CA 19.9 (three of the original six) and has a level 4 over 5 according to the criteria of Justice et al. (multiple independent validations) [Ann. Intern. Med.1999; 130: 515]. AD - 061 Accident and Emergency Service, Huelva, Spain. FAU - Villadiego-Sanchez, J M AU - Villadiego-Sanchez JM FAU - Ortega-Calvo, M AU - Ortega-Calvo M FAU - Pino-Mejias, R AU - Pino-Mejias R FAU - Cayuela, A AU - Cayuela A FAU - Iglesias-Bonilla, P AU - Iglesias-Bonilla P FAU - Garcia-de la Corte, F AU - Garcia-de la Corte F FAU - Santos-Lozano, J M AU - Santos-Lozano JM FAU - Lapetra-Peralta, Jose AU - Lapetra-Peralta J LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20090130 PL - Australia TA - Int J Med Sci JT - International journal of medical sciences JID - 101213954 SB - IM PMC - PMC2640476 OID - NLM: PMC2640476 EDAT- 2009/02/14 09:00 MHDA- 2009/02/14 09:00 CRDT- 2009/02/14 09:00 PHST- 2008/09/10 [received] PHST- 2009/01/29 [accepted] PHST- 2009/01/30 [epublish] PST - ppublish SO - Int J Med Sci. 2009;6(1):43-50. Epub 2009 Jan 30. PMID- 19187100 OWN - NLM STAT- Publisher DA - 20090203 IS - 1365-2796 (Electronic) DP - 2009 Jan 30 TI - Circulating biomarkers of angiogenesis as indicators of left ventricular systolic dysfunction amongst patients with coronary artery disease. AB - Abstract. Patel JV, Abraheem A, Chackathayil J, Gunning M, Creamer J, Hughes EA, Lip GYH (City Hospital, Birmingham; and University Hospital of North Staffordshire, Stoke-on-Trent, UK). Circulating biomarkers of angiogenesis as indicators of left ventricular systolic dysfunction amongst patients with coronary artery disease. J Intern Med 2009; doi: 10.1111/j.1365-2796.2008.02057.xBackground. Patients with coronary artery disease (CAD) and left ventricular systolic dysfunction (LVSD) are often asymptomatic. Angiogenesis is implicated in the physiology of vascular repair and cardiac remodelling, and is one of many pathophysiological processes implicated in heart failure. We hypothesized that plasma indices associated with angiogenesis [angiogenin, vascular endothelial growth factor (VEGF), and angiopoietin (Ang)-1 and Ang-2] would be abnormal in CAD patients with LVSD, being correlated with EF and wall motion abnormalities (wall motion score) independently of underlying CAD (coronary atheroma score). We also evaluated the specificity of angiogenic 'biomarkers' in their detection of LVSD [ejection fraction (EF) <40%] amongst CAD patients. Methods. Using a cross sectional approach, we measured angiogenin, VEGF, Ang-1 and Ang-2 by ELISA in 194 CAD patients (aged 34-81 years) undergoing elective coronary angiography. Results. Levels of angiogenin were inversely related with EF (r = -0.17, P = 0.02) and positively with coronary atheroma scores (r = 0.15, P = 0.04, but not independently of EF). Other angiogenic markers were unrelated to objective measures of LVSD but VEGF (P = 0.008) and Ang-2 (P = 0.015) were lower amongst those patients with heart failure. Angiogenin levels were related to wall motion scores (r = 0.16, P = 0.024). Conclusion. Heart failure has a modest impact on biomarkers of angiogenesis, in patients with CAD. Further research is warranted into the diagnostic and prognostic utility of biomarkers of angiogenesis, in this common cardiac condition. AD - From the Haemostasis Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham, UK. AU - Patel JV AU - Abraheem A AU - Chackathayil J AU - Gunning M AU - Creamer J AU - Hughes EA AU - Lip GY LA - ENG PT - JOURNAL ARTICLE DEP - 20090130 TA - J Intern Med JT - Journal of internal medicine JID - 8904841 EDAT- 2009/02/04 09:00 MHDA- 2009/02/04 09:00 CRDT- 2009/02/04 09:00 AID - JIM2057 [pii] AID - 10.1111/j.1365-2796.2008.02057.x [doi] PST - aheadofprint SO - J Intern Med. 2009 Jan 30. PMID- 19155146 OWN - NLM STAT- Publisher DA - 20090121 IS - 0344-0338 (Print) DP - 2009 Jan 18 TI - Hepatic composite tumor in a patient with primary sclerosing cholangitis. AB - A focal intrahepatic enhancing lesion with associated bile duct stricture was identified in a 25-year-old woman with a history of primary sclerosing cholangitis (PSC) who was being evaluated for increasing liver enzymes. Partial hepatectomy was performed, revealing a composite tumor with neuroendocrine and cholangiocarcinomatous differentiation. Only one composite tumor of the liver has been previously reported in the literature [H. Hidaka, S. Kuwao, S. Kokubu, K. Yanagimoto, A. Satomichi, M. Takada, T. Nakazawa, K. Saigenji, Mixed carcinoid-adenocarcinoma of the liver, Intern. Med. 39 (2000) 910-913], and to our knowledge, this is the first report of such a tumor in association with PSC. We report this very unusual case and discuss the potential association of neuroendocrine carcinoma with primary sclerosing cholangitis. AD - Department of Pathology and Laboratory Medicine, University of Wisconsin Hospital and Clinics, Madison, WI, USA. AU - Koplin S AU - Agni R LA - ENG PT - JOURNAL ARTICLE DEP - 20090118 TA - Pathol Res Pract JT - Pathology, research and practice JID - 7806109 EDAT- 2009/01/22 09:00 MHDA- 2009/01/22 09:00 CRDT- 2009/01/22 09:00 PHST- 2008/07/03 [received] PHST- 2008/11/20 [accepted] AID - S0344-0338(08)00280-X [pii] AID - 10.1016/j.prp.2008.11.008 [doi] PST - aheadofprint SO - Pathol Res Pract. 2009 Jan 18. PMID- 19141097 OWN - NLM STAT- Publisher DA - 20090114 IS - 1365-2796 (Electronic) DP - 2009 Jan 6 TI - Atrial fibrillation in fracture patients treated with oral bisphosphonates. AB - Abstract. Abrahamsen B, Eiken P, Brixen K (Copenhagen University Hospital, Gentofte; Hillerod Hospital, Hillerod; and Odense University Hospital, Odense; Denmark). Atrial fibrillation in fracture patients treated with oral bisphosphonates. J Intern Med 2009; doi:10.1111/j.1365-2796.2008.02065.x Objectives. To determine if patients receiving oral bisphosphonates are at excess risk of atrial fibrillation (AF), stroke and myocardial infarction. Design. Register-based restricted cohort study. Setting. National Hospital Discharge Register and National Prescriptions Database (1995-2005). Subjects. Fracture patients beginning bisphosphonates (n = 15 795) were matched with unexposed fracture patients of the same age, sex and fracture type (n = 31 590). Results. Incidence rates of AF were 16.5/1000 person years in untreated fracture patients and 20.6/1000 person years in bisphosphonate users. An age- and sex-adjusted hazard ratio (HR) of 1.29 (1.17-1.41) was found for probable AF by Cox proportional hazards analysis. The effect size was reduced to HR of 1.18 (1.08-1.29) by adjustment for co-medications and comorbidity. Selective prescribing was suggested by the observation that (i) risks were increased even in patients who stopped therapy after the first packet and (ii) risks were not increased by high adherence. Bisphosphonate-exposed patients were at increased risk of hospital-treated AF [adjusted HR: 1.13 (1.01-1.26)], but the risk amongst bisphosphonate users was inversely proportional to adherence. There was no increased risk of ischaemic stroke and an increased risk of myocardial infarction was not significant after adjustment for comorbidity. Conclusions. The increased occurrence of AF in fracture patients who are users of oral bisphosphonates should be attributed to targeting of bisphosphonates to patients who are already at increased risk of cardiovascular events. AD - From the Department of Internal Medicine and Endocrinology, Copenhagen University Hospital, Gentofte, Denmark. AU - Abrahamsen B AU - Eiken P AU - Brixen K LA - ENG PT - JOURNAL ARTICLE DEP - 20090106 TA - J Intern Med JT - Journal of internal medicine JID - 8904841 EDAT- 2009/01/15 09:00 MHDA- 2009/01/15 09:00 CRDT- 2009/01/15 09:00 AID - JIM2065 [pii] AID - 10.1111/j.1365-2796.2008.02065.x [doi] PST - aheadofprint SO - J Intern Med. 2009 Jan 6. PMID- 19141093 OWN - NLM STAT- Publisher DA - 20090114 IS - 1365-2796 (Electronic) DP - 2008 Dec 23 TI - Ezetimibe monotherapy for cholesterol lowering in 2,722 people: systematic review and meta-analysis of randomized controlled trials. AB - Abstract. Pandor A, Ara RM, Tumur I, Wilkinson AJ, Paisley S, Duenas A, Durrington PN, Chilcott J (University of Sheffield, Sheffield; and University of Manchester, Manchester; UK). Ezetimibe monotherapy for cholesterol lowering in 2,722 people: systematic review and meta-analysis of randomized controlled trials. J Intern Med 2008; doi:10.1111/j.1365-2796.2008.02062.x Objectives. To study the evidence on the efficacy and safety of ezetimibe monotherapy for the treatment of primary (heterozygous familial and non-familial) hypercholesterolaemia. Design. Systematic review and meta-analysis of randomized controlled trials (RCTs). Methods. Eleven electronic bibliographic databases covering the biomedical, scientific and grey literature were searched from inception and supplemented by contact with experts in the field. Two reviewers independently determined the eligibility of RCTs, with a minimum treatment duration of 12 weeks, which compared ezetimibe monotherapy (10 mg per day) with placebo. Results. In the absence of data from clinical outcome trials, surrogate endpoints such as changes in lipid concentrations were used as indicators of clinical outcomes. A meta-analysis of eight randomized, double-blind, placebo-controlled trials (all 12 weeks) showed that ezetimibe monotherapy was associated with a statistically significant mean reduction in LDL cholesterol (from baseline to endpoint) of -18.58%, (95% CI: -19.67 to -17.48, P < 0.00001) compared with placebo. Significant (P < 0.00001) changes were also found in total cholesterol (-13.46%, 95% CI: -14.22 to -12.70), HDL cholesterol (3.00%, 95% CI: 2.06-3.94) and triglyceride levels (-8.06%, 95% CI: -10.92 to -5.20). Ezetimibe monotherapy appeared to be well tolerated with a safety profile similar to placebo. Conclusions. In a meta-analysis restricted to short-term trials in hypercholesterolaemia, significant potentially favourable changes in lipid and lipoprotein levels relative to baseline occurred with ezetimibe monotherapy. Further long-term studies with cardiovascular and other clinical outcome data are needed to assess the efficacy and safety of ezetimibe more fully. AD - Health Economics and Decision Science, University of Sheffield, Sheffield, UK. AU - Pandor A AU - Ara RM AU - Tumur I AU - Wilkinson AJ AU - Paisley S AU - Duenas A AU - Durrington PN AU - Chilcott J LA - ENG PT - JOURNAL ARTICLE DEP - 20081223 TA - J Intern Med JT - Journal of internal medicine JID - 8904841 EDAT- 2009/01/15 09:00 MHDA- 2009/01/15 09:00 CRDT- 2009/01/15 09:00 AID - JIM2062 [pii] AID - 10.1111/j.1365-2796.2008.02062.x [doi] PST - aheadofprint SO - J Intern Med. 2008 Dec 23. PMID- 19124166 OWN - NLM STAT- Publisher DA - 20090106 IS - 1872-6976 (Electronic) DP - 2009 Jan 3 TI - PTH-analogs: Comparable or different? AB - Because no comparative studies exist, no clear pronouncements can be made about the potential differences in effectiveness and safety between PTH 1-34 and PTH 1-84. As regards the efficacy, a convincing reduction of vertebral fractures was shown in both cases [Neer, R.M., Arnaud, C.D., Zanchetta, J.R., Prince, R., Gaich, G.A., Reginster, J.Y., Hodsman, A.B., Eriksen, E.F., Ish-Shalom, S., Genant, H.K., Wang, O., Mitlak, B.H., 2001. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N. Engl. J. Med. 344, 1434-1441; Greenspan, S.L., Bone, H.G., Ettinger, M.P., Hanley, D.A., Lindsay, R., Zanchetta, J.R., Blosch, C.M., Mathisen, A.L., Morris, S.A., Marriott, T.B., Treatment of Osteoporosis with Parathyroid Hormone Study Group, 2007. Effect of recombinant human parathyroid hormone (1-84) on vertebral fracture and bone mineral density in postmenopausal women with osteoporosis: a randomized trial. Ann. Intern. Med. 146, 326-339]. A reduction of non-vertebral fractures was shown in the case of PTH 1-34 only. Another significant resemblance is that both medicines have a strong anabolic action; this mechanism of action is essentially different from the bisphosphonates and strontium ranelate. Both medicines constitute a welcome addition to the therapeutic arsenal for patients with severe osteoporosis. More data from literature (including information on follow-up data and use in men) are available for PTH 1-34 because it has been available for longer. As regards the side effect profile, PTH 1-84 appears to have a higher incidence of hypercalcemia, hypercalciuria and nausea than teriparatide. Here, too, no comparative study exists: the differences may therefore be based on an actual difference in side effects, or it may be ascribed to differences in definitions and/or patient populations. AD - Department of Geriatric Medicine, University Medical Centre Utrecht, P.O. Box 85.500 (Room B05.256), 3508 GA Utrecht, The Netherlands. AU - Verhaar HJ AU - Lems WF LA - ENG PT - JOURNAL ARTICLE DEP - 20090103 TA - Arch Gerontol Geriatr JT - Archives of gerontology and geriatrics JID - 8214379 EDAT- 2009/01/07 09:00 MHDA- 2009/01/07 09:00 CRDT- 2009/01/07 09:00 PHST- 2008/05/13 [received] PHST- 2008/11/01 [revised] PHST- 2008/11/05 [accepted] AID - S0167-4943(08)00225-2 [pii] AID - 10.1016/j.archger.2008.11.004 [doi] PST - aheadofprint SO - Arch Gerontol Geriatr. 2009 Jan 3. PMID- 19026855 OWN - NLM STAT- MEDLINE DA - 20081125 DCOM- 20081224 IS - 1532-8643 (Electronic) VI - 51 IP - 3 DP - 2008 Nov-Dec TI - Public access defibrillators and fire extinguishers: are comparisons reasonable? PG - 204-12 AB - Sudden cardiac death is a major cause of mortality in the United States of America (Circulation 2008;117:e25-146) with approximately 310000 deaths related to coronary heart disease occurring in emergency departments or in the prehospital environment annually. Several organizations have directed resources toward the treatment of sudden cardiac arrest through a paradigm that has come to be known as the "chain of survival"-prompt activation of emergency response by telephone 911, early bystander cardiopulmonary resuscitation, early defibrillation, and timely advanced cardiac life support (Circulation 1991;83:1832-1847). The ready availability of automated external defibrillators (AEDs) has been advocated as a key component of this chain. Some authors have suggested a "fire extinguisher model" for AED deployment (Circulation 1998;98:2334-2351; Resuscitation 1995;30:151-156; Ann Intern Med 2001;135:990-998). In this model, AEDs are prominently displayed in public places for use by laypersons, much like fire extinguishers. For example, in Chicago's O'Hare Airport, AEDs are placed alongside fire extinguishers in the public concourse (N Engl J Med 2002;347:1242-1247). Advocates of this model suggest that advancing this practice would be a means to widely disbourse life-saving technology that is easy to use. Several experts have questioned this model, suggesting that the cost-effectiveness of distributing AEDs this widely would be prohibitive (BMJ 2002;325:515; Curr Opin Cardiol 2007;22:5-10; BMJ 2003;326:162; Int J Technol Assess Health Care 2007;23:362-367) and may not be more effective than more targeted distribution of AEDs. This literature review will examine the available data on both AEDs and fire extinguishers to determine if these comparisons are reasonable as a means of guiding public policy. AD - Department of Emergency Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210-1228, USA. FAU - Mell, Howard K AU - Mell HK FAU - Sayre, Michael R AU - Sayre MR LA - eng PT - Journal Article PT - Review PL - United States TA - Prog Cardiovasc Dis JT - Progress in cardiovascular diseases JID - 0376442 SB - AIM SB - IM MH - Cardiopulmonary Resuscitation MH - Coronary Disease/*complications MH - Death, Sudden, Cardiac/etiology/*prevention & control MH - *Defibrillators/standards MH - Emergency Medical Services MH - *Fire Extinguishing Systems MH - Heart Arrest/mortality/therapy MH - Humans RF - 51 EDAT- 2008/11/26 09:00 MHDA- 2008/12/25 09:00 CRDT- 2008/11/26 09:00 AID - S0033-0620(08)00039-X [pii] AID - 10.1016/j.pcad.2008.05.003 [doi] PST - ppublish SO - Prog Cardiovasc Dis. 2008 Nov-Dec;51(3):204-12. PMID- 18852410 OWN - NLM STAT- MEDLINE DA - 20081014 DCOM- 20081028 IS - 1538-3679 (Electronic) VI - 168 IP - 18 DP - 2008 Oct 13 TI - Notice of duplicate publication: "Potentially harmful effect of a testosterone dietary supplement on prostate cancer growth and metastasis" (arch intern med. 2008;168[2]:235-236). PG - 2046-7 AD - Department of Urology, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9110. Shahrokh.Shariat@UTSouthwestern.edu FAU - Shariat, Shahrokh F AU - Shariat SF FAU - Roehrborn, Claus G AU - Roehrborn CG FAU - Lamb, Dolores J AU - Lamb DJ FAU - Slawin, Kevin M AU - Slawin KM LA - eng PT - Corrected and Republished Article PT - Journal Article PL - United States TA - Arch Intern Med JT - Archives of internal medicine JID - 0372440 RN - 0 (Androgens) RN - 58-22-0 (Testosterone) SB - AIM SB - IM CRF - Arch Intern Med. 2008 Jan 28;168(2):235-6. PMID: 18227373 MH - Androgens/administration & dosage/*adverse effects MH - Dietary Supplements/*adverse effects MH - Disease Progression MH - *Duplicate Publication as Topic MH - Humans MH - Male MH - Neoplasm Metastasis MH - Prognosis MH - Prostatic Neoplasms/diet therapy/*pathology MH - Testosterone/administration & dosage/*adverse effects EDAT- 2008/10/15 09:00 MHDA- 2008/10/29 09:00 CRDT- 2008/10/15 09:00 AID - 168/18/2046-a [pii] AID - 10.1001/archinte.168.18.2046-b [doi] PST - ppublish SO - Arch Intern Med. 2008 Oct 13;168(18):2046-7. PMID- 18688681 OWN - NLM STAT- MEDLINE DA - 20081121 DCOM- 20090326 IS - 1525-1497 (Electronic) VI - 23 IP - 11 DP - 2008 Nov TI - Takotsubo cardiomyopathy. PG - 1904-8 AB - BACKGROUND: Takotsubo cardiomyopathy is a novel, yet well-described, reversible cardiomyopathy triggered by profound psychological or physical stress with a female predominance. OBJECTIVE: This review is designed to increase general clinician awareness about the diagnosis, incidence, pathogenesis, and therapies of this entity. DATA SOURCES: A complete search of multiple electronic databases (Pubmed, EMBASE, Science Citation Index) was carried out to identify all full-text, English-language articles published from 1980 to the present date and relevant to this review. REVIEW METHODS: The following search terms were used: takotsubo cardiomyopathy, stress-induced cardiomyopathy, and left ventricular apical ballooning syndrome. Citation lists from identified articles were subsequently reviewed and pertinent articles were further identified. RESULTS: Takotsubo cardiomyopathy is typically characterized by the following: 1) acute onset of ischemic-like chest pain or dyspnea, 2) transient apical and mid-ventricular regional wall-motion abnormality, 3) minor elevation of cardiac biomarkers, 4) dynamic electrocardiographic changes, and 5) the absence of epicardial coronary artery disease. The pathogenesis of the syndrome is unknown but has mostly been associated with acute emotional or physiologic stressors. Dote, Sato, Tateishi, Uchida, Ishihara (J Cardiol. 21(2):203-214, 1991); Desmet, Adriaenssens, Dens (Heart. 89(9):1027-1031, Sep., 2003); Bybee, Kara, Prasad, et al. (Ann Intern Med. 141(11):858-865, Dec 7, 2004); Sharkey, Lesser, Zenovich, et al. (Circulation. 111(4):472-479, Feb 1, 2005) The short and long-term prognosis of these patients is overwhelmingly favorable and often only requires supportive therapy. CONCLUSION: Whether an emotional or physical event precedes one's symptoms, it is apparent that takotsubo cardiomyopathy case presentations mimic ST-segment elevation myocardial infarction, and thus is an important entity to be recognized by the medical community. AD - The Zena and Michael A. Wiener Cardiovascular Institute and The Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Medical Center, New York, NY 10029-4802, USA. brett.sealove@gmail.com FAU - Sealove, Brett A AU - Sealove BA FAU - Tiyyagura, Satish AU - Tiyyagura S FAU - Fuster, Valentin AU - Fuster V LA - eng PT - Case Reports PT - Journal Article PT - Review DEP - 20080808 PL - United States TA - J Gen Intern Med JT - Journal of general internal medicine JID - 8605834 SB - IM CIN - J Gen Intern Med. 2009 Feb;24(2):286. PMID: 19089509 MH - Electrocardiography MH - Female MH - Humans MH - Male MH - Middle Aged MH - Sex Distribution MH - Stress, Psychological/complications/physiopathology MH - Takotsubo Cardiomyopathy/*diagnosis/*physiopathology RF - 21 PMC - PMC2585677 OID - NLM: PMC2585677 [Available on 11/01/09] EDAT- 2008/08/09 09:00 MHDA- 2009/03/27 09:00 CRDT- 2008/08/09 09:00 PMCR- 2009/11/01 PHST- 2008/03/10 [received] PHST- 2008/07/03 [accepted] PHST- 2008/06/11 [revised] PHST- 2008/08/08 [aheadofprint] AID - 10.1007/s11606-008-0744-4 [doi] PST - ppublish SO - J Gen Intern Med. 2008 Nov;23(11):1904-8. Epub 2008 Aug 8. PMID- 18651046 OWN - NLM STAT- In-Data-Review DA - 20080724 IS - 1205-6626 (Print) VI - 11 IP - 2 DP - 2006 Summer TI - Cost and utility of a low-molecular-weight heparin and unfractionated heparin for treatment of deep venous thrombosis in a Balkan country: A model analysis. PG - 111-6 AB - OBJECTIVE: Low-molecular-weight heparins are cost-saving for treating venous thrombosis in developed countries, but their cost-effectiveness in developing Balkan countries has not been investigated. The objective of the present study was to evaluate whether the results of cost-effectiveness studies of low-molecular-weight heparins versus unfractionated heparin for treatment of acute deep venous thrombosis conducted in a developed country are applicable to Serbian socioeconomic circumstances. METHODS: A Markov model was constructed based on the decision model used by Gould et al (Ann Intern Med 1999;130:789-99), with the help of TreeAge Software (TreeAge Software Inc, USA). Probabilities for clinical outcomes were obtained from that study, while the costs were derived from the Serbian Republic Institute for Health Insurance and other sources. Patients with acute deep venous thrombosis, 60 years of age, were introduced into the model. A Monte Carlo microsimulation trial with 1000 patients was used for drawing conclusions from the model. The time horizon was six years, and the Serbian Republic Institute for Health Insurance was used. RESULTS: Enoxaparin for treatment of deep venous thrombosis in Serbian patients was not cost-saving, but was a cost-effective therapeutic strategy (from 5,322.97 CSD [Serbia and Montenegro dinars] per quality-adjusted life-year gained when used in out-patients, to 10,929.76 CSD per quality-adjusted life-year gained when used in inpatients). The drug acquisition cost was the major factor influencing the cost-effectiveness, due to the low cost of labour and hospitalization. CONCLUSIONS: The results of pharmacoeconomic studies performed in developed countries cannot be directly extrapolated to developing Balkan countries. However, enoxaparin is still a cost-effective strategy for the treatment of deep venous thrombosis. AD - Pharmacology Department, Medical Faculty, University of Kragujevac, Kragujevac, Serbia and Montenegro. FAU - Jankovic, Slobodan M AU - Jankovic SM FAU - Milovanovic, Dragan R AU - Milovanovic DR LA - eng PT - Journal Article PL - Canada TA - Exp Clin Cardiol JT - Experimental and clinical cardiology JID - 9715903 PMC - PMC2274855 OID - NLM: PMC2274855 EDAT- 2008/07/25 09:00 MHDA- 2008/07/25 09:00 CRDT- 2008/07/25 09:00 PST - ppublish SO - Exp Clin Cardiol. 2006 Summer;11(2):111-6. PMID- 18501315 OWN - NLM STAT- MEDLINE DA - 20080526 DCOM- 20081009 IS - 1550-7289 (Print) VI - 4 IP - 3 Suppl DP - 2008 May-Jun TI - Review of meta-analytic comparisons of bariatric surgery with a focus on laparoscopic adjustable gastric banding. PG - S47-55 AB - BACKGROUND: In a prior systematic review and meta-analysis of the large body of literature describing the laparoscopic adjustable gastric band (LAGB), outcomes for the Swedish Adjustable Gastric Band (SAGB) and Lap-Band (LB), in particular, were reviewed. This article summarizes those results and discusses them in relation to the 3 other published bariatric surgery meta-analyses (JAMA 2004;292:1724-37; Ann Intern Med 2005;142:547-59; and Surgery 2007;142:621-32). METHODS: In the gastric banding meta-analysis, systematic review included screening of 4,594 studies published in any language (Jan 1, 1998-April 30, 2006). Studies with at least 10 SAGB or LB patients reporting > or =30-day efficacy or safety outcomes were eligible for review; data were extracted from accepted studies. Weighted means analysis and random-effects meta-analysis of efficacy outcomes of interest were conducted. RESULTS: In the gastric banding meta-analysis, 129 studies (patients n = 28,980) were accepted (33 SAGB/104 LB studies). In 4,273 patients (36 treatment groups) in 33 SAGB studies, and in 24,707 patients (111 groups) in 104 LB studies, mean baseline age (39.1-40.2 yrs), body mass index ([BMI] 43.8-45.3 kg/m2), and sex (females 79.2%-82.5%) were similar. Three-year mean SAGB/LB excess weight loss (56.36%/50.20%) was significant, as was resolution of type 2 diabetes (61.45%/60.29%) and hypertension (62.95%/43.58%) (P < .05). Adverse event (AE) rates appeared comparable, and early mortality was equivalent (< or =.1%). DISCUSSION: In the SAGB and LB meta-analysis at 1, 2, and 3 years, weight loss, resolution of diabetes and hypertension, and adverse events appeared equivalent. All meta-analyses that assessed weight loss found that bariatric surgery produced clinically significant reductions in excess weight across procedures in the short term. One meta-analysis found that bariatric surgery produced significantly more weight loss than medical treatment in patients with BMI >40 kg/m2 in the short term, with malabsorptive procedures producing the greatest weight loss. All studies reporting on comorbidities showed significant resolution or improvement of type 2 diabetes mellitus ([T2DM] > or =60%), hypertension (> or =43%), and dyslipidemia (> or =70%). In one meta-analysis, surgery was found to be superior to medical therapy in resolving T2DM, hypertension, and dyslipidemia. Sleep apnea was significantly resolved/improved in > or =85% across procedures in the one meta-analysis that addressed this comorbidity. One meta-analysis found no differences in AEs between procedures; however, the laparoscopic approach was associated with significantly reduced AEs. In the 4 meta-analyses, mortality was low (.1%-1.11%) for all procedures. Bariatric surgery was observed to be a safe and highly effective therapy for morbid obesity. Heterogeneity in nomenclature, study methods, statistical detail, definitions of weight-loss success and comorbid disease resolution, and completeness of data sets did not allow for comparison of some variables. Initiatives including the Iowa Bariatric Surgery Registry (IBSR), the Longitudinal Assessment of Bariatric Surgery (LABS) consortium, the Surgical Review Corporation (SRC) Center of Excellence initiative, and the Bariatric Outcomes Longitudinal Database [BOLD] are working to improve data standardization, which, in turn, will facilitate summary and comparison of bariatric surgery outcomes. AD - Center for Weight Loss, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA. Scott.Cunneen@cshs.org FAU - Cunneen, Scott A AU - Cunneen SA LA - eng PT - Journal Article PT - Meta-Analysis PT - Review PL - United States TA - Surg Obes Relat Dis JT - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JID - 101233161 SB - IM MH - Bariatric Surgery/adverse effects/*methods MH - Body Mass Index MH - Comorbidity MH - Gastroplasty/adverse effects/*methods MH - Humans MH - Laparoscopy/adverse effects/methods MH - Obesity, Morbid/complications/*surgery MH - Weight Loss RF - 33 EDAT- 2008/07/03 09:00 MHDA- 2008/10/10 09:00 CRDT- 2008/07/03 09:00 AID - S1550-7289(08)00422-X [pii] AID - 10.1016/j.soard.2008.04.007 [doi] PST - ppublish SO - Surg Obes Relat Dis. 2008 May-Jun;4(3 Suppl):S47-55. PMID- 18558146 OWN - NLM STAT- MEDLINE DA - 20080618 DCOM- 20081023 IS - 0013-7006 (Print) VI - 34 IP - 3 DP - 2008 Jun TI - [Depressive disorders and quality of life: a cross sectional study including 360 depressive patients followed at the psychiatry consultation of the Mahdia university hospital] PG - 256-62 AB - INTRODUCTION: Depressive disorders affect many psychosocial and functional aspects, leading to a real social handicap and an alteration in quality of life. AIM OF THE STUDY: Our purposes were to evaluate the depressive patient's quality of life and to identify the risk factors responsible for this deterioration. DESIGN: Our cross sectional study lasted for four months, from 1st March to 30th June 2003, and included 360 depressive patients followed at the psychiatry consultation of the university hospital in Mahdia. The data were collected with a questionnaire composed of 60 items exploring the general characteristics of subjects, the clinical and evolutional characteristics of depressive disorder and providing information on the treatment. Quality of life was measured using the SF-36 (short form) generic scale. A global average score was calculated and it was considered that quality of life was altered if the score was less than 66.7, according to the threshold value of Lean [Arch Intern Med 159 (1999) 837-843]. Moreover, an average score was calculated for each dimension, thus permitting us to identify those most affected. We standardized initial average scores. RESULTS: The assessment of quality of life revealed a global average score of 44.6 and an alteration in 81% of patients. The study of the dimensional average scores revealed that all dimensions were affected. The standardization also revealed deterioration in all the dimensions, with the mental component particularly more affected than the physical component with respectively estimated scores of 37.3 and 39.1. The analytic approach concerned the relationship between qualitative and quantitative variables and the occurrence of an alteration in quality of life. For this effect, a bivariate study displayed a statistically significant correlation between the eight dimensions of the SF-36 and 20 variables. In order to take into account the relationships which link each variable to the others, and to avoid the bias of the bivariate study, a logistic regression analysis was carried out. Only 12 variables with truly discriminating weight emerged from this analysis. According to the number of dimensions affected, the following factors were classified in decreasing order: the presence of at least two suicide attempts, the association of a psychotropic, the partial or absent observance, the feminine gender, the presence of somatic diseases, the absence of autonomy, the low social-economic level, the presence of a recent hospitalization (<12 months), the age greater than 45 years, the marital status of widow or separated, the number of children under charge greater than five and the presence of severe side effects. CONCLUSION: This clinimetric approach permitted us to consider the whole life of each patient suffering from depressive disorder, rather than just the angle of their illness. AD - Service de psychiatrie, CHU de Tahar-Sfar, 5111 Mahdia, Tunisia. hadjammar_mohamed@yahoo.fr FAU - Hadj Ammar, M AU - Hadj Ammar M FAU - Khammouma, S AU - Khammouma S FAU - Nasr, M AU - Nasr M LA - fre PT - English Abstract PT - Journal Article TT - Troubles depressifs et qualite de vie: etude transversale aupres de 360 patients consultant en psychiatrie au CHU de Mahdia. DEP - 20071203 PL - France TA - Encephale JT - L'Encephale JID - 7505643 SB - IM MH - Adult MH - Cross-Sectional Studies MH - Depressive Disorder/*diagnosis/*psychology MH - Female MH - Follow-Up Studies MH - *Hospitals, University MH - Humans MH - Male MH - Quality of Life/*psychology MH - *Referral and Consultation MH - Severity of Illness Index MH - Tunisia EDAT- 2008/06/19 09:00 MHDA- 2008/10/24 09:00 CRDT- 2008/06/19 09:00 PHST- 2006/03/13 [received] PHST- 2006/11/13 [accepted] PHST- 2007/12/03 [aheadofprint] AID - S0013-7006(07)00016-4 [pii] AID - 10.1016/j.encep.2006.11.001 [doi] PST - ppublish SO - Encephale. 2008 Jun;34(3):256-62. Epub 2007 Dec 3. PMID- 18477339 OWN - NLM STAT- MEDLINE DA - 20080514 DCOM- 20080530 LR - 20081231 IS - 1572-0241 (Electronic) VI - 103 IP - 5 DP - 2008 May TI - A significant decline in the American domination of research in gastroenterology with increasing globalization from 1980 to 2005: an analysis of American authorship among 8,251 articles. PG - 1065-74 AB - AIM: To determine whether the relative American contribution to gastroenterology research, as determined by authorship in journals, decreased from 1980 to 2005. METHODS: Country of residence for authors was manually determined for 8,251 articles, encompassing every gastroenterologic article published in 1980 and 2005 in nine gastroenterology and four leading medical journals (8 American and 5 European journals). Country of residence was also determined for all editorial board members for the same years in the same journals. RESULTS: In all eight analyzed American journals, the relative frequency of non-American authors significantly and sharply increased from 1980 to 2005, and of American authors correspondingly decreased. The effect was invariant: (a) regardless of journal field: general medicine (e.g., N Engl J Med, from 10.1% in 1980 to 27.2% in 2005, odds ratio [OR] 3.34, OR confidence interval [CI] 2.40-4.62, P < 0.0001) versus general gastroenterology (e.g., Am J Gastroenterol, from 20.8% in 1980 to 51.9% in 2005, OR 4.29, OR CI 2.81-6.55, P < 0.0001); (b) regardless of journal gastroenterology subspecialty (e.g., Hepatology vs Endoscopy); (c) regardless of journal circulation: high circulation (e.g., Ann Intern Med, OR 3.50, OR CI 2.05-5.96, P < 0.0001) versus lower circulation (e.g., J Clin Gastroenterol, OR 6.88, OR CI 2.86-16.5, P < 0.0001); (d) regardless of journal impact factor: high impact (e.g., N Engl J Med, see above) versus lower impact (e.g., Dig Dis Sci, OR 3.06, OR CI 2.08-4.51, P < 0.0001); (e) regardless of article topic within a journal (e.g., colon vs upper gastrointestinal tract); (f) regardless of article length within a journal; (g) regardless of number of authors per article or order of authorship; and (h) regardless of whether international representation on the journal's editorial board increased (e.g., Am J Gastroenterol) or decreased (J Clin Gastroenterol) from 1980 to 2005. Contrariwise, in three of five analyzed European journals, the opposite effect occurred: the relative frequency of non-American authors statistically significantly decreased from 1980 to 2005 (e.g., Aliment Pharmacol Ther, from 87.9% in 1980 to 75.9% in 2005, OR 0.43, OR CI 0.20-0.94, P < 0.033), and of Americans authors correspondingly increased. The same trend generally held for the editorial boards of analyzed journals: the relative frequency of non-American board members significantly increased in five American journals (e.g., Am J Gastroenterol, from 4.2% in 1980 to 31.3% in 2005, OR 10.5, OR CI 1.68-63.5, P= 0.006), and decreased in all five analyzed European journals. Interstate and transnational collaborations (coauthorship) increased in publications from 1980 to 2005 (e.g., transnational, from 2.8% in 1980 to 14.1% in 2005 in N Engl J Med, OR 5.62, OR CI 3.25-9.73, P < 0.0001). CONCLUSIONS: From 1980 to 2005, American representation in American gastroenterologic journals significantly declined, whereas American representation in European gastroenterologic journals moderately increased. The latter finding, together with increased transnational collaboration and increased international representation in editorial boards, suggests that increasing globalization of information, partly due to computers and the Internet, may be an important etiologic factor. This may result in an improving quality of research performed outside America. Other potential etiologic factors include improving standard of living outside America and increasing clinical volume of academic gastroenterologists in America. AD - Division of Gastroenterology, William Beaumont Hospital, Royal Oak, Michigan, USA. FAU - Cappell, Mitchell S AU - Cappell MS FAU - Davis, Michael AU - Davis M LA - eng PT - Journal Article PL - United States TA - Am J Gastroenterol JT - The American journal of gastroenterology JID - 0421030 SB - IM CIN - Am J Gastroenterol. 2008 Nov;103(11):2941-2; author reply 2942-3. PMID: 19032474 CIN - Am J Gastroenterol. 2008 Nov;103(11):2943; author reply 2943-4. PMID: 19032477 MH - *Authorship MH - *Cross-Cultural Comparison MH - Forecasting MH - Gastroenterology/*trends MH - Humans MH - Research/*trends MH - United States EDAT- 2008/05/15 09:00 MHDA- 2008/05/31 09:00 CRDT- 2008/05/15 09:00 AID - AJG1767 [pii] AID - 10.1111/j.1572-0241.2007.01767.x [doi] PST - ppublish SO - Am J Gastroenterol. 2008 May;103(5):1065-74. END -