Extended heart failure clinic follow-up in low-risk patients: a randomized clinical trial (NorthStar).

Background: Outpatient follow-up in specialized heart failure clinics (HFCs) is recommended by current guidelines and implemented in most European countries, but the optimal duration of HFC programmes has not been established. Nor is it known whether all or only high-risk patients, e.g.

Prevalence and inter-relationship of different Doppler measures of dyssynchrony in patients with heart failure and prolonged QRS: a report from CARE-HF.

Background: Cardiac resynchronisation therapy (CRT) improves mortality and morbidity in heart failure patients with wide QRS. Observational studies suggest that patients having more left ventricular dyssynchrony pre-implantation obtain greater benefit on ventricular function and symptoms with CRT.

Aim: To provide an analysis of the prevalence and type of dyssynchrony in patients included in the CARE-HF trial.

Design and methodology of the NorthStar Study: NT-proBNP stratified follow-up in outpatient heart failure clinics -- a randomized Danish multicenter study.

Background: Randomized clinical trials have shown that newly discharged and symptomatic patients with chronic heart failure (CHF) benefit from follow-up in a specialized heart failure clinic (HFC). Clinical stable and educated patients are usually discharged from the HFC when on optimal therapy. It is unknown if risk stratification using natriuretic peptides could identify patients who would benefit from longer-term follow-up.

Effects of pentoxifylline on the vascular response to injury after angioplasty in rabbit iliac arteries.

Pentoxifylline (PTX) inhibits the effects of several cytokines and reduces injury-related collagen accumulation. The aim of the present study was to investigate the effect of PTX on the vascular response to injury. We treated rabbits with PTX (100 mg/kg/day) or placebo (saline) subcutaneously from 2 days before angioplasty of an iliac artery until euthanasia 7 or 28 days later.

Detection of chromosomal abnormalities, congenital abnormalities and transfusion syndrome in twins.

Objective: To evaluate the outcome of screening for structural malformations in twins and the outcome of screening for twin-twin transfusion syndrome (TTTS) among monochorionic twins through a number of ultrasound scans from 12 weeks' gestation.

Methods: Enrolled into this prospective multicenter observational study were women with twin pregnancies diagnosed before 14 + 6 gestational weeks. The monochorionic pregnancies were scanned every second week until 23 weeks in order to rule out early TTTS.

Strain rate and tissue tracking imaging in quantitation of left ventricular systolic function in endurance and strength athletes.

Aim: The aim of this study was to assess the impact of long-term physical training on left ventricular longitudinal contraction by strain rate analysis and tissue tracking imaging.

Methods And Results: The study population comprised 17 male elite endurance and 15 male elite strength athletes and 12 male control subjects of similar age. Tissue Doppler imaging was recorded in the apical views and used for analysis of the longitudinal systolic myocardial velocity, annular diastolic velocities, strain rate and tissue tracking.

Adventitial myofibroblasts play no major role in neointima formation after angioplasty.

Objective: Myofibroblasts migrating from adventitia have been suggested to constitute a majority of neointimal cells after angioplasty. We sought to examine this hypothesis by use of smoothelin, which is a marker for the quiescent smooth muscle cell (SMC) phenotype while not expressed by myofibroblasts.

Design: Balloon angioplasty was performed in left iliac arteries of 25 rabbits that were killed after 3-56 days.

[Transcatheter occlusion of patent ductus arteriosus].

Percutaneous closure of a patent arterial duct was performed in 58 patients. A Rashkind double umbrella was inserted in 20 patients. A supplementary double umbrella or coils were implanted in four who had residual leaks after 12 months.

Short-term changes in the immune system of elite swimmers under competition conditions. Different immunomodulation induced by various types of sport.

This study was designed to investigate changes in the immune system of elite swimmers compared with well-conditioned age- and sex-matched controls in relation to a competition swim (field study). Furthermore, the aim was to reveal possible differences in immune system changes depending on the type of sport performed by comparing with an earlier study of similar design, from the same laboratory that tested elite runners in relation to a competition run. The swimmers were tested before, immediately after and 2 h and 24 h after a competition swim.

Lymphocyte redistribution in connection with physical activity in the rat.

Previous studies have demonstrated numerous immunobiological changes in connection with exercise. A decrease in peripheral blood mononuclear white cells (PBMC) 2 h after intense exercise has been shown. This lymphocytopenia in humans after exercise is thought to be of great importance regarding the morbidity to viral infection.

Cytokine plasma levels and lymphocyte subsets in patients with newly diagnosed insulin-dependent (type 1) diabetes mellitus before and following initial insulin treatment.

Changes in the plasma concentrations of interleukin-1 beta (IL-1 beta), tumour necrosis factor alpha (TNF alpha), interleukin 2 (IL-2), and lymphocyte subsets were investigated in 19 persons with newly diagnosed (type 1) insulin-dependent diabetes mellitus (IDDM) from admission to hospital prior to insulin treatment and following 1 week and 1 month of treatment. Furthermore, the cytokines were measured 16-28 months after the presentation of IDDM. The mean TNF alpha values were all within the normal range, but demonstrated a slight increase in all the samples taken (Friedman 0.

Decreased interleukin-1 beta levels in plasma from rheumatoid arthritis patients after dietary supplementation with n-3 polyunsaturated fatty acids.

The effects of dietary supplementation with n-3 fatty acids on the level of cytokines and complement activation in plasma from patients with rheumatoid arthritis were examined. Thirty-two patients with active rheumatoid arthritis were included in a 12-week double-blind, randomized study of dietary supplementation with n-3 fatty acids (3.6 g per day) or placebo.

Tumour necrosis factor alpha and interleukin-2 in plasma from rheumatoid arthritis patients in relation to disease activity.

Tumour necrosis factor alpha (TNF alpha) and interleukin-2 (IL-2) are potential immunological mediators of pathogenetic changes in rheumatoid arthritis. We measured the concentrations of TNF alpha and IL-2 in plasma from 2 groups of patients suffering from rheumatoid arthritis (RA). One group had high and one had low disease activity.

Plasma atrial natriuretic peptide in elite runners.

Plasma atrial natriuretic peptide (ANP) was measured in relation to a 5-km race in 11 elite mid- and long-distance runners. Plasma ANP, measured in relation to the race, was compared with the relative changes in plasma volume and the physical fitness of the runners. Relative changes in plasma volume were estimated by changes in hemoglobin and hematocrit, and physical fitness was evaluated by a cycle ergometer test, running time, and resting heart-rate.

Comparative study of assays detecting complement activation. Complement-split product C3d (rocket immuno-electrophoresis) and C3d neodeterminants (ELISA).

The aim of the study was to investigate the correlation between two types of assay measuring specific products of complement C3 activation and their clinical application. Complement C3d split product was estimated using double-decker rocket immunoelectrophoresis (DD-RIE) and measurements of C3d neodeterminants exposed after C3 activation was carried out with an enzyme-linked immunosorbent assay (ELISA). A total of 595 blood samples were measured in parallel in the DD-RIE and the ELISA test systems.

Effect of physical exercise on cytokines and lymphocyte subpopulations in human peripheral blood.

To examine the effect of intensive physical exercise on interleukin 2 (IL-2), tumor necrosis factor alpha (TNF alpha) and lymphocyte subsets, eleven elite and well-conditioned runners were tested in relation to a five-kilometer race. IL-2 was significantly decreased (p less than 0.01) immediately after the exercise and significantly increased after 24 hours (p less than 0.

Reduction of complement activation in rheumatoid arthritis by steroid treatment.

Patients with severe active active rheumatoid arthritis (RA) have higher than normal plasma concentrations of the complement C3 split-product C3d, indicating increased complement activation. Treatment with steroids reduced plasma C3d levels in these patients. Ten patients with classic or definite RA and high disease activity were studied during six days of treatment with steroids.

[Polyglandular autoimmune syndrome type II].

The polyglandular autoimmune syndrome type II, (Schmidts syndrome), is defined as coexistence of two of the diseases: Addison's disease, insulin dependent diabetes mellitus and autoimmune thyroid disease. The first endocrine deficiency state typically develops after the age of twenty and in most cases it is Addison's disease. The prevalence is approximately 5 per 100,000.

[Lipids in the plasma of voluntary blood donors. A 2-year retrospective study (1985-1987)].

In a regional blood transfusion centre, we observed 45 episodes of hyperlipidemic plasma among the 45,000 units produced from 12,000 unpaid volunteer blood donors during a two year period. Analysis of fasting serum cholesterol and serum triglycerides showed that 26 of the 45 were raised in either one or both of the values. Dietary instructions were given, in most cases through their general practitioners, who were informed of the results.

Passive tension of the ankle before and after stretching.

The passive tension resulting from dorsiflexion of the ankle was measured in relation to stretching in six handball players and six soccer players. Corresponding values of ankle angle and passive tension were measured by a strain gauge and a potentiometer connected to a pedal system. The passive tension versus ankle angle was measured before and 90 minutes after a single contract-relax stretching program of the plantar flexors.

Quantitation of the stretch reflex. Technical procedures and clinical applications.

The stretch reflex should ideally be quantitated for better clinical use by standardizing the muscle stretch and measuring the resulting muscle contraction. Quantitation of muscle contraction can be done by force measurements or electromyographic recordings. The electromyographic response to stretch consists of one component (short latency response) for short stretches (less than 15 ms) and of 2 or 3 components (short and long latency responses) for longer stretches (greater than 40-50 ms).

[Stretching in relation to sports and prevention of injuries].

Stretching is a regular item in training programmes and it is employed to increase flexibility, to prevent muscle tenderness, overuse injuries and strains. Stretching is carried out by stretching muscles and connective tissue to the extreme positions of joints. A review of stretching exercises based on the literature is presented in relation to prevention of injuries.

Pyomyositis: a report on two cases from a region with a temperate climate.

Two cases of pyomyositis in Caucasians, from a region with temperate coastal climate is reported. The identification of staphylococci as an aetiological factor in both temperate and tropical regions is mentioned, and so are other possible identical aetiological factors.