ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00995.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00996.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00997.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00998.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Twenty‐one cases of renal tubular acidosis presenting with periodic hypokalaemic muscular weakness, that were seen over an 8‐year period, are presented. The biochemical features suggested a diagnosis of distal renal tubular acidosis and absence of family history with negative screening of eighteen families pointed towards the primary sporadic nature of the disorder in nineteen of the cases. Alkali and replacement potassium therapy resulted in immediate and sustained clinical recovery in all the ca

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00999.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Serum concentrations of seven acute‐phase reactants: albumin, transferrin (Tf), alpha‐1‐antitrypsin (AIAT), caeruloplasmin (Cp),α2‐macroglobulin (α2‐MG), haptoglobin (hp) and C‐reactive protein (CRP) were determined in 73 subjects with varying severities of homozygous sickle cell (HbSS) disease. Fifty healthy subjects of comparable sex, age and socio‐economic class distributions as the HbSS subjects served as controls. Albumin andα2‐MG were comparable in all the subject groups. Tf and hp levels were significantly reduced in the HbSS groups relative to the control group. Conversely, AIAT, CRP and CP were significantly elevated. However only Tf and CRP manifested significant correlations with any of the indices of disease severity employed. Transferrin and CRP are suggested as plasma proteins worthy of further evaluation as indicators of severity in homozygous s

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb01000.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Objectives. To explore the possible pathogenetic role of erythropoietin (EPO) in the anaemia associated with cyclosporin (Cs) in newly diagnosed patients with insulin‐dependent diabetes mellitus (IDDM).Design. A multicentre randomized placebo controlled prospective trial of Cs immunosuppression for 12 months in IDDM patients.Setting. Patients were recruited from the out‐patient clinics of diabetes centres in Europe and Canada.Subjects. Patients 9–35 years old with a clinical diagnosis of ketonuric IDDM entering less than 6 weeks after diagnosis. 188 patients were originally recruited; 105 patients completed the investigation, 52 patients being treated with Cs, and 53 patients receiving placebo.Interventions. Random allocation to receive either Cs or placebo. The initial dose of Cs was 10 mg kg−1BW day−1. Therapy was maintained for 12 months.Main outcome measures. B‐Haemoglobin, s‐creatinine, and s‐EPO concentrations were monitored before, during and after therapy with either Cs or placebo.Results. Blood‐haemoglobin (Hgb) fell from 8.5 ± 0.8 to a nadir of 7.8 ± 0.9 mmol l−1at 6 months (P<0.0001) in IDDM patients treated with Cs but not in the placebo patients (8.5 ± 0.8 to 8.8 ± 0.9 mmol l−1, NS). The mean serum EPO levels remained unaltered throughout the 6‐month period of Cs and placebo therapy. No significant differences in serum EPO levels between Cs and placebo‐treated diabetic patients were found after 6 months of treatment.Conclusions. The light anaemia associated with Cs therapy in IDDM patients is not related to an insufficient production of EPO, but is caused by other, as yet unknown mechanisms, unrelated to the ne

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb01001.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Objectives. To examine the relationships between alcohol intake, obesity, plasma insulin concentration and serum activities of three liver enzymes in obese men with mild hypertension.Design. A 6‐week run‐in period followed by randomization to either diet treatment or antihypertensive drug treatment, lasting for 1 year. Alcohol intake was estimated using questionnaires. Plasma insulin concentration, serum activities of gamma‐glutamyl transferase, and aspartate and alanine aminotransferase, respectively, were measured at entry and after 1 year.Setting. Out‐patient clinic, city hospital.Patients. Sixty‐four men aged 40–69 years with a body mass index>26 kg m−1and with mild untreated hypertension. Exclusion criteria were alcoholism and diabetes mellitus. Sixty‐one patients completed the study.Interventions. Dietary treatment was based upon weight reduction and recommendations about a low alcohol intake. Drug treatment used a stepped‐care approach with atenolol as the first‐choice drug.Main outcome measures. Serum activities of the liver enzymes, body weight, body mass index, alcohol intake, plasma insulin concentration.Results. Body weight decreased by 7.8 kg in the diet group and increased by 1.0 kg in the drug‐treated group. Alcohol intake did not differ between the groups before or after 1 year. Serum gamma‐glutamyl transferase activity correlated with alcohol consumption; it showed no significant change after weight loss. At entry, serum activities of aspartate and alanine aminotransferases correlated to plasma insulin concentration independent of body mass index. Weight reduction significantly lowered serum activities of these liver enzymes as well as plasma insulin concentrations and normalized elevated serum activity of alanine aminotransferase in a majority of the cases.Conclusion. Alcohol intake was an important determinant for elevated serum gamma‐glutamyl transferase activity. The degree of obesity was a contributing factor for elevations of serum alanine aminotransferase activity. We speculate that insulin may play a

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb01002.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Objective. To evaluate the recurrence of foot ulcers as well as the cumulative amputation and mortality rates in diabetic patients with previous foot ulcers.Design. A prospective study of consecutively presenting diabetic patients admitted to the Department of Internal Medicine because of foot ulcer with a median follow‐up of 4 years.Setting. A multidisciplinary foot‐care team.Population. Five‐hundred‐and‐fifty‐eight consecutive diabetic patients with foot ulcers treated between 1 July 1983 and 31 December 1990 were followed to final outcome. Out of these patients, 468 healed either primarily (n =345) or after minor or major amputations (n= 123) and 90 died before healing had occurred. Those 468 patients who healed were included in this prospective study from the time of healing.Main outcome measures. Patients were followed according to a standardized protocol with registration of foot lesions, amputation, morbidity and mortality. Clinical examination was performed twice yearly.Results. After 1, 3 and 5 years of observation 34%, 61% and 70% of the patients, respectively, had developed a new foot ulcer. The recurrence rate of foot lesions was slightly higher among patients who previously had had an amputation (P<0.05,P<0.01 and non‐significant, respectively). Among patients with previous primary healing the cumulative amputation rates were 3%, 10% and 12% after 1, 3 and 5 years of follow‐up compared with 13%, 35% and 48% among those who previously healed after amputation, irrespective of previous amputation level (P<0.001 at all time‐points). All amputations except three were initiated by a foot ulcer deteriorating to deep infection or progressive gangrene. The long‐term survival ratio was lower among patients healed after previous amputation (80%, 59%, 27%) compared with patients with previously primary healing (92%, 73%, 58%) after 1, 3 and 5 years of observation, respectively (P<0.001.P<0.01 andP<0.001 respectively). The mortality rate was twice as high among primarily healed and four times as high among patients with amputation compared to an age‐ and sex‐matched Swedish population.Conclusion. These findings stress the need for life‐long surveillance of the diabetic foot at risk and the necessity of preventive foot care among diabetic patients with previous foot lesions, and particularly among those who had

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb01003.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.A 79‐year‐old man developed a renal insufficiency while on thiazide. Extrarenal symptoms were absent. Screening for antibodies revealed high titre for anti‐myeloperoxidase and anti‐cardiolipin antibodies, but no other antibodies were present. After withdrawal of the drug the progression of renal insufficiency ceased. Four months later the both antibodies had disappeared. We conclude, that antibodies against granulocytes will become a valuable diagnostic tool in diagnosing drug‐induced v

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb01004.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY