ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00183.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00184.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.A total of 1280 80‐year‐old men were invited to a medical examination to study common risk indicators for cardiovascular disease (CVD) in the elderly. From the pool of 811 responders (63.3%), all 122 individuals who fulfilled our inclusion criteria were assigned to one of four groups: (1) no CVD, non‐smokers; (2) no CVD, smokers; (3) CVD, smokers; (4) CVD, non‐smokers. A telephone interview with 75 non‐responders suggested that this group contained more institutionalized subjects, but otherwise did not differ from the group of participants. Subjects with CVD had higher levels of plasma cholesterol and LDL cholesterol than those without CVD, whereas plasma HDL cholesterol and plasma triglyceride concentrations did not differ between the groups; thus the LDL/HDL ratio was higher in the CVD group. Lipoprotein concentrations did not differ between smokers and non‐smokers. However, the mean cholesterol levels were low (5.19 ± 1.01 mmol l−1), suggesting selective mortality. No differences between the groups were found with regard to Lp(a). The mean blood pressure for the whole group was 149/79 mmHg, and there were no differences between subgroups.Our study suggests that mechanisms such as selective mortality modify the risk factor pattern in the elderly. In 80‐year‐old individuals, elevated LDL cholesterol levels can still be identified as a risk indicator for CVD, whereas there does not appear to be any association between CVD or low HDL levels or elevated blood pressure

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00185.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.A total of 1280 80‐year‐old men in the community of Malmö were questioned about smoking habits and the occurrence of cardiovascular disease (CVD). After a careful medical and duplex ultrasound examination, four groups were selected for further studies: (1) no CVD, non‐smokers; (2) no CVD, smokers; (3) CVD, smokers; (4) CVD, non‐smokers. In total 122 individuals participated. The average tobacco consumption by smokers was 13 g d−1for 59 years. In the CVD group 45% of subjects had atherosclerotic symptoms at more than one site. Smoking was found to be correlated with lower extremity atherosclerosis, cholesterol and LDL cholesterol were correlated with carotid artery lesions and pathological ankle/arm index, and blood pressure was correlated with lower extremity lesions. In contrast with middle‐aged populations, individuals with an increasing degree of lesions in the lower extremities had a larger percentage of high glutathione transferase activity than subjects without CVD. Smokers had significantly lower pyridoxal‐5‐phosphate levels than non‐smokers. It is concluded that some heavy smokers might reach an advanced age in good health. Smoking was also operative as a risk indicator for lower extremity atherosclerosis in 80‐

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00186.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.A 25‐year‐old woman with a history of Graves' disease, in remission for 8.5 years following 6 months of methimazole therapy, first came to our attention 5 months after her first delivery with clinical and biochemical hypothyroidism, markedly elevated titre of anti‐thyroid microsomal antibody (MCHA;1: 102400) and mildly elevated activity of thyrotropin‐binding inhibitory immunoglobulins (TBII; 29.5%). After short‐term (3 months) treatment with L‐thyroxine therapy, the development of hyperthyroidism in the first trimester of the second pregnancy, which remitted through the second and third trimesters, was observed. TBII showed a peak value (93.1%) 1 month after the onset of hyperthyroidism, and a normal value (12.4%) 6 d after delivery. One month after the second delivery, the patient developed hyperthyroidism, with an elevation of99mTc thyroid uptake (5.58%; normal range 0.5–2.5%), which was immediately followed by transient clinical and biochemical hypothyroidism. Concomitant increases in MCHA titre and TBII activity were observed after delivery, and both reached peak levels (1: 409600 and 81.0%, respectively) one and a half months after the onset of hypothyroidism. Thyroid‐stimulating antibody (TSAb), measured using FRTL‐5 thyroid cells, was detected at a weakly positive level (161%) on initial examination, and the serial change in TSAb was almost identical to that in TBII.Patients with Graves' disease may develop Graves' type hyperthyroidism, followed immediately by transient hypothyroidism due to coexisting destructive autoimmune thyroiditis during the early postpartum period, despite increas

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00187.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.One plethysmographic and two thermographic methods were evaluated against venography in 102 patients with suspected deep vein thrombosis (DVT). Seventy‐one patients had venographically verified DVT, which in 21 cases was restricted to the calf. Plethysmography (PG) gave a sensitivity and specificity of 63% and 94%, respectively. The former was influenced by a limited sensitivity of 14% in the sub‐group with distal DVT. The sensitivity and specificity of temperature profiles (TP) were 87% and 39%, respectively, while the corresponding values for thermo‐camera (TC) were 83% and 55%, respectively. Using a combined diagnostic approach of PG and TP, additional evaluation of posterior and lateral profiles and pattern recognition. 96% sensitivity and 81% specificity were reached. The combination of PG and TP will be an essential diagnostic complement when venography is not possible or inconclusive, as well as having a role in diagnostic screening in a large number of pat

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00188.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.The aim of this study was to investigate whether beta‐2‐adrenergic stimulation with inhaled salbutamol is therapeutically useful in hyperkalaemia. Ten patients with renal failure and hyperkalaemia (serum potassium concentration>6 mmol l−1) were given 1 5 mg salbutamol via a nebulizer over a 30‐min period. Serum potassium was measured 30. 60, 180 and 360 min thereafter. All patients had end‐stage renal failure on chronic hospital haemodialysis. Serum potassium levels decreased significantly from a pretreatment value of 6.5 ± 0.6mmol l−1to 5.6 ± 0.6mmol−1after 30 min, and this level was maintained for 3 h. Six hours after treatment, the serum potassium concentration was 6 ± 0.7 mmol l−1. There was a modest increase in heart rate and blood glucose level, but otherwise salbutamol was well tolerated and no serious side‐effects occurred. It is concluded that the administration of salbutamol by inhalation is a simple, safe and reasonably effective method for treatment of hyperkalae

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00189.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.A group of patients with primary hypothyroidism has been studied, and it is reported that low serum levels of thyroid hormones are accompanied by low plasma atrial natriuretic peptide (ANP) concentrations. While the correlation between ANP and thyroid hormone levels is strong, no correlation was found between ANP and heart rate or arterial blood pressure. It is suggested that thyroid hormones directly stimulate the release of ANP from atrial cardiocytes.

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00190.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.An unusual hereditary myopathy with paroxysmal myoglobinuria has been described previously. We have studied muscle biopsy specimens taken before and after exercise to exhaustion (24 min at 20–25 W) in a young woman with this condition. Marked glycogenolysis with lactate production and marked phosphagen breakdown (ATP + CP) were observed after exercise, and almost all type I fibres were found to be depleted of glycogen. Succinate dehydrogenase (SDH) activity was low, while the activities of 3‐OH‐acyl‐CoA‐dehydrogenase, phosphofructokinase, phosphorylase and lactate dehydrogenase were normal. On electron microscopy, the mitochondria showed abnormalities typical of mitochondrial myopathy. The findings in our patient suggest a limitation of mitochondrial function, probably related to SDH in the tricarboxylic acid cycle and complex II in the electron transport chain. This may explain the inability of ATP regeneration to keep pace with ATP utilization during exercise. Other metabolic defects ma

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00191.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.In order to improve our understanding of the dose‐concentration and concentration‐effect relationships, the pharmacokinetics of recombinant erythropoietin were studied after the initial dose (n =6) and after repeated doses (n =9) administered intravenously in patients with chronic renal failure. Several venous blood samples were collected before (to obtain the baseline concentration) and after an intravenous dose of erythropoietin. A radioimmunoassay was used to determine the erythropoietin concentration in the samples. The apparent volume of distribution at steady state was 4.2 ± 0.9 1 (initial dose) and 3.7 ± 0.61 (repeated dosing), which is close to the assumed plasma volume in these patients. The half‐life was 5.3 ± 1.3 h and 5.8 ± 1.2 h in the two groups, respectively, and is therefore too short for any accumulation to be expected when dosing three times per week. Consequently, no difference in baseline values could be detected between the groups. The clearance of erythropoietin in the groups was estimated to be 11.4 ± 7.0 ml min−1and 7.8 ± 3.8 ml min−1, respectively. Erythropoietin kinetics did not differ after repeated dosing compared to the single initial dose. Intravenous administration of erythropoietin will result in high peak concentrations followed by a rapid decline

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00192.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY