ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb00938.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract.As yet, the pathogenesis of Kaposi'i sarcoma in the context of the acquired immunodeficiency syndrome (AIDS) is not completely understood; this is also true for the mechanisms of action of interferon‐alpha against this tumour. The present review focuses on recent developments that may provide some further insight into these issues. These include the angiogenesis of the tumour and the possible role of growth factors, such as the HIV‐transactivating (tat) gene product and interleukin‐6, the possible meaning of immunomodulating activities of interferon‐alpha, such as the rise in the number of CD4+ cells and the increase in beta2‐microglobulin serum concentrations in patients whose tumours respond to treatment, and the observed association between interferon'n antiretroviral activity and tumour

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb00939.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract.Seven patients with angina pectoris and 201‐thallium scintigraphy indicative of myocardial perfusion defects, but with normal coronary angiograms, were investigated. Metabolic events were studied in biopsies from myocardium and skeletal muscle (m. quadriceps femoris). Profound metabolic derangement was evidenced by a distinctly lowered energy charge in myocardium (0.88 ± 0.04 in controls vs. 0.48 ± 0.09 in patients:P<0.001) and skeletal muscle (0.92 ± 0.01 in controls vs. 0.70 ± 0.09 in patients:P<0.01). Accordingly, low values were recorded for ATP in both types of muscle, where ATP was lower than (myocardium) or the same as (skeletal muscle) ADP. The concentration of myocardial lactate was 115 ± 74 μmol g‐1dry weight and that of skeletal muscle lactate was 11 ± 3 μmol g‐1dry weight, compared to normal myocardial lactate of 18 ± 10 μmol g‐1dry weight and normal skeletal muscle lactate of 11 ± 3 μmol g‐1dry weight. Unprecedentedly low energy charge levels in both cardiac and skeletal muscle biopsies suggest that a systemic metabolic disease is highly probable. An inverse ATP/ADP ratio found in our patients is indicative of an aetiology different from ischaemia, which would not prod

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb00940.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract.The effect of heavy drinking and sauna bathing on cardiac rhythm, blood pressure, and serum electrolyte and cortisol concentrations was studied in 10 healthy male volunteers. Sauna bathing induced a comparable, significant increase in heart rate with and without alcohol consumption. During sauna bathing without alcohol, systolic blood pressure remained at the baseline level, whereas sauna and alcohol together decreased systolic blood pressure markedly from 136 ± 4 to 113 ± 3 mmHg (P<0.01). Neither sauna alone, nor sauna combined with alcohol intake, increased the frequency of premature ventricular complexes. Serum potassium, calcium and cortisol concentrations changed slightly during sauna, but alcohol consumption did not contribute further to this. In conclusion, sauna bathing, even in combination with heavy drinking, does not appear to provoke cardiac arrhythmias in healthy young men. However, the risk of hypotension is increased when sauna bathing is combined with alcohol consumptio

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb00941.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract.A total of 395 consecutive patients with biopsy‐proven glomerulonephritis were followed up for 14 years. At the time of entry to the study the patients were classified as having one of nine states of kidney disease according to serum creatinine levels and proteinuria. The transitions of the patients between the nine states were analysed. The influence of 14 independent variables including treatment with cytostatic drugs and prednisolone was estimated by the Cox proportional hazard model. Treatment with immunosuppressive drugs had an influence that emerged within the first month and continued for the next 2 months. Subsequent treatment with cytostatic drugs in combination with prednisolone delayed further improvement. Treatment with prednisolone or cytostatic drugs as single therapy for up to 6 months increased the risk of improvement of the disease, and had no significant effect on deterioration. The beneficial effect of the treatment persisted after withdrawal of the immunosuppressive drugs. The analysis revealed only a slight influence of the histological character of the glomerular changes. Post‐streptococcal glomerulonephritis carried an increased tendency for improvement. Arterial hypertension affected the process in several states of kidney disease. Heavy proteinuria increased the risk of increasing serum creatinine lev

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb00942.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract.The association between smoking habits and diet was examined in a sample of 1126 men, aged 45–64 years, from the general population living in the three French MONICA monitoring areas: Bas‐Rhin (BR) (n= 346), Haute‐Garonne (HG) (n= 400) and Urban Community of Lille (UCL) (n= 380). Diet was assessed by the 3‐day record method. The energy and nutrient intakes were calculated for each of the 3 centres, using the same food composition tables. Alcohol consumption was higher among smokers (P<0.001). Taking into account alcohol consumption, age, body mass index, centre, educational level and family size, the analyses showed no difference in non‐alcoholic energy intake, proteins, carbohydrates, and total fat. However, smokers had a lower intake of polyunsaturated fatty acids (P<0.05) and dietary fibre (P<0.01) than non‐smokers. With regard to food items, smokers had a higher intake of sucrose (P<0.05) and a lower intake of vegetables (P<0.001), dairy products (P<0.05) and cheese (P<0.05). These results suggest that analyses in future epidemiological research regarding the role of diet in the aetiology of tobacco‐related diseases should consider this association of potential

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb00943.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract.We examined the effect of light smoking in relation to incidence of coronary heart disease (CHD) in a general population sample consisting of 6879 men aged 47–55 years and free of previous myocardial infarction (MI) at baseline. After a follow‐up of mean duration 11.8 years, 11.0% of men smoking 1–4 cigarettes daily (n= 228) had suffered a major CHD event, compared to 3.7% of non‐smokers (n= 2049) [adjusted odds ratio 2.8 (1.7‐4.7)]. No further increase in risk was observed in men who smoked more. There was an increasing risk of death from cancer with the number of cigarettes smoked per day. Mortality was increased in all categories of cigarette smokers, particularly among the very heavy smokers, who had a mortality risk of 22% compared to 6% among non‐smokers [adjusted odds ratio 4.4 (2.7‐7.1)]. Data from an examination 4 years later considered only those men who stated that their smoking habits were identical on both occasions (n= 3981). Among these subjects the incidence of CHD after a mean period of 7.1 years was 10.6% in men smoking 1–4 cigarettes per day. compared to 2.6% in non‐smokers [adjusted O.R. 4.6 (2.1–10.1)]. No dose‐response effect was observed. Even very light cigarette smoking considerably increases the risk of C

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb00944.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract.We determined whether ketoconazole prophylaxis might reduceCandidacolonization and infections in adult patients with acute leukaemia. During first‐remission induction therapy 50 patients were treated with 200 mg ketoconazole administered orally daily, while 57 patients received placebo in a double‐blind, randomized trial. The duration of severe neutropenia (granulocytes<0.1 times 109l‐1) represented 36% of the study period in the ketoconazole group and 26% in the placebo group (P= 0.043). Although fewer patients presented with positiveCandidasurveillance cultures and serological evidence ofCandidainfection in the ketoconazole group compared to the placebo group, two candidaemias and oneTrichosporumfungaemia were observed in the ketoconazole group. Moreover, significantly more bacteraemias were noted in the ketoconazole group (n= 37) than in the placebo group (n= 21) (P= 0.004). Thus, although oral ketoconazole prophylaxis might be associated with lessCandidacolonization and fewer seroconversions, it also resulted in more bacteraemias and longer duration of severe neutropenia, suggesting that caution should be exercised when ketoconazole (or related drugs) is given to this group of immunocompromised

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb00945.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract.In order to define patients at high risk for inappropriate antibiotic treatment of bacteraemia, we compared 682 bacteraemic patients, treated with an antibiotic drug to which the infecting micro‐organism was susceptible, with 419 patients who were inappropriately treated. On a multivariate logistic regression analysis including only clinical variables, four factors were found to be both significantly and independently associated with inappropriate antibiotic treatment: hospital‐acquired bacteraemia (oddsratio (OR) of 1.9), antibiotic treatment in the month prior to the bacteraemia (OR 1.9), residence in a nursing home (OR 1.8), and the presence of a central line (OR 1.7). A second model, including bacteriological data, showed four micro‐organisms to be independently associated with inappropriate antibiotic treatment:Candidasp. (OR 14.2),Acinetobactersp. (OR 5.0),Enterococcussp. (OR 3.6) andPseudomonassp. (OR 2.2). In this model, only two clinical features were included: hospital‐acquired infection and previous antibiotic treatment. Special efforts should be made to improve empirical antibiotic treatment in the groups defined above, and to facilitate early laboratory diagnosis of the micro‐organisms associated with inappropriate

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb00946.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract.An anonymous survey was conducted on 302 Spanish clinical investigators in order to determine whether a patient't information sheet should be prepared for each clinical trial, and what items of information should be included. The survey, using close‐response type questions, included 23 proposed items of information. A total of 275 (91%) investigators considered it necessary that a patient't information sheet be prepared for each clinical trial. At least 83% of those investigators considered that seven items of information should always be included: an invitation to participate in a clinical trial, the aim of the study, a description of the predictable benefits and risks, a declaration that participation is voluntary, and a statement that refusal to participate does not imply loss of normal medical care and that the trial has been approved by a Clinical Trials Committee. Only 29% and 53% considered that the patient should always be informed about clinical trial design and data confidentiality, respectively. Overall, the responses obtained are in line with most of the elements of informed consent regarded as ‘basic’ in US regulations and included in the European Community and Nordic Good Clinical Practice guide

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb00947.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY