ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1989.tb01357.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractBerntorp K, Ekman M, Berntorp E (Department of Internal Medicine. University of Lund, Malmö General Hospital, Malmö, Sweden). Cigarette smoke impairment of human lymphocyte function by inhibition of transglutaminase.Thein‐vitroandin‐vivoeffects of cigarette smoke were studied in human peripheral blood lymphocytes by applying a method for the capping of β2‐microglobulin‐ or phytohaemagglutinin (PHA)‐stimulated lymphocyte transformation (measured as (3H)thymidine incorporation) involving the transglutaminase pseudosubstrate monodansylthiacadaverine (MDTC), whose presence resulted in significantly reduced capping and (3H)thymidine incorporation in a concentration‐dependent manner.The addition of dimethyl sulphoxide‐soluble particles from cigarette smoke to lymphocytesin vitrosignificantly reduced the capping ability and the PHA‐induced (3H)thymidine incorporation. Whereas no significant change in MDTC‐dependent capping inhibition was seen in lymphocytes from smokers after 10 d abstinence from smoking, there was a marked decrease in (3H)thymidine incorporation in lymphocytes from smokers after smoking three cigarettes following 10 h abstinence.The tentative conclusion is that exposure to cigarette smoke, or smoke extract, impairs MDTC‐dependent capping inhibition and PHA‐stimulated lymphocyte transformation by tra

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1989.tb01358.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractReichard P, Rosenqvist U (Department of Internal Medicine II, The Southern Hospital, and Stockholm County Council Teaching Centre for Diabetes (LUCD). Stockholm, Sweden). Nephropathy is delayed by intensified insulin treatment in patients with insulin‐dependent diabetes mellitus and retinopathy.Patients with insulin‐dependent diabetes mellitus (IDDM) and non‐proliferative retinopathy were randomized to intensified conventional insulin treatment (ICT,n= 44) or regular treatment (RT,n= 51).During a 3‐year period the glycosylated haemoglobin (HbA1c) levels were reduced to a greater extent (P= 0.00001) in the ICT group (from 9.5 ± 0.2 to 7.4%,P= 0.0001) than in the RT group (9.4 ± 0.2 to 9.0 ± 0.2.P= 0.004).The urinary albumin excretion rate (UAER) increased significantly (P= 0.033) in the RT group but not in the ICT group, and the UAER differed significantly (P= 0.031) between the groups after 3 years.The mean HbA1c values during the study period independently influenced the deterioration of UAER levels (P= 0.029). Initial diastolic blood pressure (P= 0.112). the HbA1c value at entry (P= 0.480) and the smoking habits (P= 0.959) were not related to change of UAER levels.Manifest nephropathy after 3 years was seen almost exclusively in patients with HbA1c levels above 9%. Improved blood glucose control, without ‘near normoglycaemia’, delayed the progression of nephropathy in patients with IDDM a

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1989.tb01359.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractNielsen OJ, Thaysen JH (Medical Department P, Division of Nephrology, Rigshospitalet, Copenhagen, Denmark). Response to erythropoietin in anaemic haemodialysis patients.An open non‐randomized clinical trial with recombinant human erythropoietin (rhEpo) was conducted in 10 chronic haemodialysis patients with considerable iron overload. Pretreatment serum erythropoietin levels were significantly decreased for the degree of anaemia (22.0 ± 7.6 mUnits (U) ml−1).Initially all patients received 120 U kg−1of rhEpo intravenously three times a week and after a period of 45 days the haematocrit rose from 25 ± 3 to 36 ± 5. A reduced dose of 30 U kg−1was then instituted which stabilized the haematocrit at this level.The development of anti‐erythropoietin antibodies to rhEpo could not be demonstrated. Endogenous serum erythropoietin levels remained unchanged during therapy with rhEpo. The serum ferritin concentration, which was initially 3118 ± 1556 μg l−1. was significantly reduced to 2203 ± 1299 μg l−1after an 80‐d treatment period.The side‐effects in three patients included the occasional sensation of increased body heat without fever. In one previously hypertensive patient the antihypertensive therapy had to be temporarily increased, but otherwise both the mean diastolic and systolic blood pressure remained constant during the observation period. No clotting of arterio

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1989.tb01360.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractChristensen JH, Freundlich M, Jacobsen BA, Falstie‐Jensen N (Department of Clinical Physiology, Aalborg Hospital, Aalborg, Denmark). Clinical relevance of pedal pulse palpation in patients suspected of peripheral arterial insufficiency.Previous studies in patients with peripheral arterial disease (PAD) have shown that the prognosis is relatively good when the distal systolic ankle index (ankle systolic pressure/arm systolic pressure) is above 50% and the distal toe systolic pressure is above 40 mmHg. In 132 patients suspected of PAD in the legs we investigated the relationship between the presence of pedal pulse and the distal systolic pressure in order to discover what diagnostic and prognostic information could be found from pulse palpation alone. The prospective study consisted of three consecutive series (A, 51 patients: B, 42 patients: and C, 39 patients); three of the authors palpated the arteries of the patients’ feet: one author in each series. The palpatory findings were related to the distal systolic pressures. When pedal pulses were present we found: (a) ankle indices above 50%: and (b) toe systolic pressures above 40 mmHg. These minimal pressure values were reproducible in the three series. Furthermore, patients lacking palpable pulses in both feet had ankle indices below 90%. We conclude: (a) if pulses are palpable on both feet of a patient the prognosis for progression is relatively good regarding the patient's PAD; (b) if pedal pulse is palpable an arteriosclerotic ulcer on the foot will heal; and (c) patients lacking palpable pulses in both feet actually suffer from

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1989.tb01361.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractSørensen PJ. Nielsen AH. Knudsen F. Schmitz O. Dyerberg J (Department of Nephrology. and Department of Clinical Chemistry. Aalborg Hospital. Aalborg. and Department of Nephrology. University Hospital of Århus. Århus. Denmark). Protein C in renal allotransplantation during the perioperative period.Protein C activity, both coagulant and amidolytic, as well as antigen level were studied during the perioperative period in 40 renal transplants recipients and 21 healthy controls. At transplantations the protein C coagulant activity was significantly lower in the patients than in the normal controls, and further decreased in the patients during the first week after transplantation, whereas the amidolytic activity of protein C was normal and the protein C antigen level was elevated. In the patients with established kidney function, protein C coagulant activity was higher than in patients with impaired graft function. Furthermore, it seems that the protein C coagulant activity was closely related to changes in graft function in the 11 patients with graft rejection episodes. The low protein C coagulant activity following renal transplantation could be a contributing factor to thromboembolic complicatio

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1989.tb01362.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractMølstad P (Medical Department. Hamar Hospital. Hamar. Norway). Primary ventricular fibrillation in acute myocardial infarction.Primary ventricular fibrillation is an acute life‐threatening event if not treated promptly. The ability to predict this event during the course of an acute myocardial infarction could therefore have an important impact on the mode of treatment and monitoring. In the present study, clinical and laboratory information available at the initial evaluation of patients with an acute myocardial infarction was tested for its ability to predict subsequent primary ventricular fibrillation. Multiple logistic regression analysis was employed to select the predictors. Serum potassium, serum creatinine and no smoking were significant predictors of subsequent ventricular fibrillation. Although the prediction was statistically significant, the clinical value of the prediction is quite limit

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1989.tb01363.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractMathiassen B, Thomsen H, Landsfeldt U (Department of Internal Medicine. Landssygehuset (Queen Alexandrina's Hospital). Torshavn. Faroe Islands). An evaluation of the accuracy of clinical diagnosis at admission in a population with epidemic meningococcal disease.The accuracy (sensitivity and positive predictive value) of the clinical diagnosis given by the general practitioner before admission to hospital was evaluated retrospectively in a population with epidemic meningococcal disease. The study population consisted of approximately 32000 subjects.In a 12‐year period, 344 patients were discharged from hospital with CNS infections, 274 of whom were admitted with a diagnosis suspecting a CNS infection. A further 401 patients were admitted with suspicion for, but discharged without a CNS infection.Overall, the sensitivity was 79.7% and the positive predictive value was 40.6%. There were no significant changes in the accuracy during the study.The sensitivity differed significantly between the age groups (P<0.001) and was lowest among the adults (15 + years, 67.9%) and the 0–2‐year‐old children (72.7%). Also among the 0–2 year‐olds, the positive predictive value was low (34.1%) and not significant, indicating that it was more difficult to obtain the correct clinical diagnosis in

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1989.tb01364.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractHöjer J, Baehrendtz S, Gustafsson L (Department of Internal Medicine, Southern Hospital, and Department of Clinical Pharmacology, Huddinge Hospital, Karolinska Institute, Stockholm, Sweden). Benzodiazepine poisoning: experience of 702 admissions to an intensive care unit during a 14‐year period.A retrospective study covering a 14‐year period was carried out to estimate the incidence and assess the clinical features of benzodiazepine (BZD) poisoning. The annual contribution of BZDs to the total number of drug overdose cases admitted to an intensive care unit displayed an increasing trend over the period, and during the last years BZDs were involved in nearly one‐third of all cases. Among the 702 cases of BZD overdosage, 144 had ingested BZD alone, 200 had poisoned themselves with BZD combined with alcohol and 358 had taken BZD with other miscellaneous drugs. In 56% of all the cases the patients had severe central nervous system depression on admission. In 47% orotracheal intubation was performed and in 18% artificial ventilation was administered. Complications were recorded in 69 of the 702 cases (9.8%) and five cases were fatal. These clinical features were essentially the same in the group that had overdosed with just BZD. In conclusion, patients with drug overdosage involving BZD have a low hospital mortality, but the acute somatic risk is not negligible. Moreover, they consume a substantial proportion of the resources in the emergency room and the intensive car

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1989.tb01365.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractGjørup T, Hendriksen C, Bugge PM, Jensen AM (Department of Medicine C, Herlev Hospital and Statistical Research Unit, University of Copenhagen, Denmark). Global assessment of patients—a bedside study. I: the influence of physical findings on the global assessment.Three physicians selected ten basic physical findings for a study of diagnostic decision making in the global assessment of patients. The physicians independently examined 201 hospital in‐patients for the presence of each of the findings and concluded their assessment with a global evaluation of whether the patient appeared ill. Each of the ten findings were used by at least one of the physicians in his overall assessment of the patient. All the observers considered ‘looking older than age’, ‘trouble with breathing’, ‘cyanosis’, and ‘anaemia’ important, but disagreed in their use of the remaining findings (P<0.01). Agreement in the global clinical assessment is an essential prerequisite to uniformity in the app

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1989.tb01366.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY