ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00235.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.tb00236.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.An isolated ventricular septal defect (VSD) was diagnosed in 70 patients (39 men and 31 women, mean age 29 years, range 10‐64 years). Surgery was judged unnecessary. The follow‐up period was at least 10 years, or until death or 31 December 1988, comprising a mean duration of 21 (range 6‐29) years. The mortality was 11/69 (one lost to follow‐up), and was not significantly higher than in a matched ‘normal’ group. Six deaths were cardiac, four of which could probably be related to the VSD. The follow‐up study revealed that: (1) 14 (22%) subjects had major, VSD‐related complications, and cardiac surgery was indicated in eight patients; (2) six (10%) had minor complications. By the end of 1988, 24% of subjects had significant dyspnoea, 22% had chest pain and 19% used cardioactive drugs. Only 33% were receiving regular cardiac control in a hospital. Thus unoperated adults with a small VSD should be monitored closely, since this condition is

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00237.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Anthropometric, hormonal and liver function parameters were examined in 18 premenopausal women with a history of early alcohol abuse, and compared with the data for randomly selected controls of the same age. The alcoholic women showed slightly elevated levels of transaminases, but no clinical or laboratory signs of advanced liver damage. These women were characterized by an increased waist‐to‐hip ratio, due to enlarged waist circumference. Several endocrine abnormalities were found, including irregular or absent menses as well as low oestrogen, progesterone and Δ‐4‐androstendione levels. The concentration of free testosterone was high and that of sex‐hormone‐binding globulin was low. These data suggest abdominal distribution of body fat, as well as hyperandrogenicity in alcoholic, premenopausal women. It is postulated that the endocrine abnormalities might be responsible for the abdominal fat

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00238.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.To determine whether an index estimating antagonism between low density lipoprotein (LDL) and high density lipoprotein (HDL) would improve separation between groups with and without coronary atherosclerosis, patients undergoing coronary catheterization (35 women and 99 men) were analysed for total cholesterol (TC), HDL cholesterol (HDLc), apolipoprotein A (apo A) and apolipoprotein B (apo B). The subjects were categorized as groups 0. 1, 2 or 3 according to the number of stenosed arteries (≥ 75% areal stenosis). Thirty of the patients showed no significant coronary atherosclerosis (group O). Serum apo B and TC concentrations were directly related to the number of stenosed vessels, whereas the concentrations of apo A and HDLcwere negatively correlated with the number of stenosed arteries. An ‘atherogenic Index’ (ATH index) calculated as the product of serum concentrations of apo B, and TC minus HDLc, divided by the product of apo A and HDLc, proved more satisfactory than individual lipoprotein components for discrimination between subjects with and without stenosis. Accordingly, identification of coronary groups may be improved by using the ATH

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00239.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.In order to evaluate the effects of one‐year antihypertensive treatment on plasma lipids and lipoproteins, 65 patients whose diastolic blood pressure was in the range 95‐120 mmHg were randomly allocated to groups that received either hydrochlorothiazide or metoprolol, or both drugs when the response to one of them was insufficient to control blood pressure. Blood pressure was effectively reduced in all groups. Patients on hydrochlorothiazide showed a significant increase (P<0.01) in low‐density lipoprotein cholesterol (LDL‐C) after 3 months of treatment. A significant increase in triglycerides was observed after 6 and 12 months, together with a decrease in high‐density lipoprotein cholesterol (HDL‐C) after 12 months (P<0.05) of treatment in patients on metoprolol. In patients treated with both hydrochlorothiazide and metoprolol, total cholesterol increased after 3 (P<0.001) and 6 months (P<0.05), triglycerides increased after 6 (P<0.01) and 12 months (P<0.01), and LDL‐C increased after 3 (P<0.05), 6 (P<0.001) and 12 months (P<0.01) of treatment, respectively. In 61% of the patients, three or more lipid parameters were affected during the study period. We conclude that long‐term antihypertensive treatment with hydrochlorothiazide, metoprolol, and particularly with both drugs, can induce lipid effects that deserve recognition, because in some cases these might counteract the possible benefit of a reduction in blood pressure on the prevention of coronar

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00240.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Blood lipids, blood pressure, body mass index (BMI), smoking, dietary and exercise habits were studied in 911 wives of men with high risk for coronary heart disease (CHD). Following the 1979/80 Tromsø Survey, 1373 men, aged 30‐54 years, were identified as having high risk for CHD (HDL‐cholesterol/total cholesterol ≤ 17.6% and/or total cholesterol ≥ 7.86 mmol l−1). Of the 1373 men, 911 individuals had wives who also attended the screening. These wives were compared to age‐matched, married women in the general population. A significantly higher total cholesterol level (5.98 mmol l−1vs. 5.78 mmol l−1), lower HDL‐cholesterol/total cholesterol (30.01% vs. 31.58%), higher BMI and higher coronary risk score (4.55 vs. 3.82) was found among the wives of the high‐risk men. Furthermore, a higher proportion of these individuals were daily cigarette smokers (47.3% vs. 42.1%), and had received fewer years of education. They also had more dietary habits associated with increased risk of CHD than other married women in the general population. Our findings support the hypothesis that members of the same household as a person with increased risk for CHD also have increased risk. This is most probably due

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00241.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.In rats, verapamil decreases intestinal absorption of calcium, increases serum parathyroid hormone (PTH), and induces osteopenia. In this prospective study, verapamil 80‐120 mg three times daily was given for 2 months to 20 patients with hypertension, and the effects on calcium homeostasis were recorded. This dose of verapamil significantly reduced supine systolic and diastolic blood pressure (±SD) from 158/100 ± 9/8 mmHg to 146/89 ± 14/8 mmHg (P=0.001). Serum alkaline phosphatase (ALP) increased significantly from 2.77 ± 1.06μkatl−1to 3.19 ± 1.22μkatl−1(P=0.004), and isoenzymes of ALP of skeletal origin appeared after verapamil treatment. The excretion of sodium in the urine increased (Na/creatinine ratio 8.95 ± 6.01 before and 13.16 ± 8.26 after verapamil;P=0.04), while the excretion of calcium, phosphate and potassium was not changed. PTH was slightly increased at the end of verapamil treatment (1.09 ± 0.54 vs. 0.98 ± 0.74μgl−1;P=0.07), and s‐1,25(OH)2D3was also somewhat increased (22.3 ± 14.4 vs. 17.6 ± 4.9 ng l−1;P=0.26). Serum Ca was not affected by verapamil (before verapamil 2.43 ± 0.11 mmol l−1, after verapamil 2.40 ± 0.12 mmol l−1;P=0.28). The increase in serum ALP demonstrates that verapamil affects bone cell metabolism in man. This effect could be secondary to t

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00242.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Sera obtained during the Hajj seasons of 1985, 1986, 1987 and 1988 from 125 heat stroke patients were collected and subjected to chemical analysis which included determination of glucose, lactate, cholesterol, and triglycerides, as well as assay of T3, T4, TSH and Cortisol. Hyperglycaemia and lactic acidaemia were found to be the most frequent metabolic abnormalities. The changes in cholesterol did not exhibit a specific pattern. Triglycerides were significantly elevated in only 6% of patients. Cortisol levels were very significantly elevated in precooled patients. Although the mean T3levels remained within the normal range, the mean concentration on admission was significantly higher than the post‐cooling mean. TSH and T4levels did not show significant change

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00243.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Microalbuminuria in non‐insulin‐dependent diabetes (NIDDM) is a strong predictor of increased mortality. The major causes of death are cardiovascular, whereas end‐stage renal failure is of low frequency. To define kidney function and the presence of some assumed cardiovascular risk factors, we compared a group of 19 microalbuminuric NIDDM patients (M), of mean age (±SD) 65 ± 4 years, and known duration of diabetes 8 ± 7 years, with 19 randomly selected matched normoalbuminuric patients (N). Seven macroalbuminuric patients (P) were also studied. Glomerular filtration rate (GFR) did not differ between N and M, whereas kidney volume was increased in M (260.3 ± 54.1 ml 1.73 m−2) compared to N (220.4 ± 44.8 ml 1.73 m−2;P=0.018). The frequency of cardiac disease increased with increasing albuminuria. Glycaemic control did not differ between the groups, but fasting plasma C‐peptide levels increased from 2.8 ± 1.1μgl−1in N, to 3.7 ± 1.7μgl−1in M (P=0.08), and to 4.2 ± 1.9μgl−1(P=0.03) in P. The lipoprotein profile showed no significant differences, although the LDLcholesterol/HDLcholesterol(LDL‐C/HDL‐C) ratio tended to rise. A significant correlation was found between C‐peptide and LDL‐C/HDL‐C (r=0.5;P<10−3). In conclusion, GFR was not increased, and did not differ between N and M, whereas kidney volume was enhanced in M. Several assumed cardiovascular risk factors showed values of

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00244.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY