ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00686.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.tb00687.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.tb00688.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.In a randomized cross‐over comparison, the effects of a mainly vegetable protein diet were compared with an animal protein diet in eight patients with cirrhosis and chronic permanent encephalopathy, under optimum lactulose therapy. After a run‐in period, patients were fed two equi‐caloric, equi‐nitrogenous diets for 7 days (71 g total proteins), containing either 50 g protein of animal origin or 50 g vegetable proteins. In the last 3 days of each period, nitrogen balance was significantly better during the vegetable protein diet (+ 0.2 (SD 1.4) g vs. — 1.7 (2.4): P<0.01), the difference being entirely due to a reduced urinary nitrogen excretion. Average daytime integrated blood glucose was slightly higher during vegetable proteins, whereas insulin, plasma amino acids and ammonia were lower. The clinical grading of encephalopathy improved slightly on vegetable proteins, and psychometric tests improved significantly, but remained grossly abnormal. Compliance to dietary manipulation was good. The data prove that a mainly vegetable protein diet is worthwhile in cirrhotic patients with chronic encephalopathy under optimum lactulose therapy. Improved nitrogen balance may be related to more effective nitrogen use for protein synthesis, probably due to blunted hormonal response, and largely outweighs the effects on encep

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00689.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.The prognostic significance of type (Q‐wave versus non‐Q‐wave) and location of infarction (anterior versus infero‐posterior) was assessed in 350 patients with a first myocardial infarction followed for 3 years. A baseline multivariate Cox model was constructed from variables assessable at entry of the index infarction. The prognostic significance of site and type of infarction was evaluated when added to this model. Both Q‐wave infarction and anterior location were significant with a risk ratio of 1.91 (95% confidence interval 1.14‐3.18) and 1.70 (95% confidence interval 1.11‐2.61) respectively. However, when the model also included the size of infarction. Q‐wave infarction was no longer formally significant, while anterior location still was associated with adverse outcome (risk ratio 1.56, 95% confidence interval 1.02‐2.39). It is inferred from the results that this effect of anterior infarction is due to a larger damage to the left ventricle for identical infarct sizes compared to infero‐po

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00690.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Thirty‐nine patients with leukaemia were followed audiometrically during treatment with broad‐spectrum antibiotics. Amikacin was given during neutropenic febrile episodes. Five patients reported a deterioration of the hearing function after termination of amikacin treatment. Significant hearing threshold loss occurred in 20 patients (51%). The hearing threshold changes were small in general, except for two patients who exhibited bilateral hearing threshold changes in the frequency range 0.5–8 kHz.Using multiple linear regression analysis 22% of the changes in hearing thresholds was estimated to be related to old age, an increased trough concentration of amikacin and an impaired pretreatment hearing state. Factors found not to influence the hearing thresholds were maximum peak concentration of amikacin, cumulative duration of therapy, pretreatment renal dysfunction and concomitant use of vancomycin.It is concluded that administration of amikacin for repeated treatment courses is associated with a low incidence of serious changes in hearing fun

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00691.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Objetive. Some observations suggest that a strict low‐salt diet may induce unfavourable metabolic side‐effects. The main aim of this study was to analyse the possible consequences of severe salt restriction in mildly hypertensive patients.Design. The study was carried out through a randomized double‐blind protocol.Subjects. Forty‐seven ambulatory patients proceeding from the hypertension unit were initially admitted: 17 were lost, and 30 non‐diabetic mildly hypertensives (DBF 90–104 mmHg) with normal renal function completed the protocol.Intervention. After a wash‐out period, patients were maintained on a low‐salt intake (2.8 ± 1.0 g day−1of NaCl) and placebo for 2 weeks, and the same diet and salt supplements (11.7± 2.5 g day−1of NaCl) for another 2 weeks, separated by a second wash‐out period.Measures. At the end of each dietary period, blood pressure (BP) and body weight were measured, and a blood sample was taken for determination of routine serum chemistries, plasma lipid and apolipoprotein concentrations, immunoreactive insulin (IRI), and plasma renin activity (PRA). Urinary 24 h excretion of sodium and potassium were measured.Results. During the salt restriction period BP did not change, weight lowered, and PRA raised. There was a significant increase in serum level of creatinine, uric acid, JRI, total cholesterol and apo B, and a decrease in HDL cholesterol and apo A‐I.Conclusion. As previously suggested, these observations seem to indicate that strict salt restriction may cause, at least in the short‐term, adverse metabolic chang

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00692.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.The release of atrial natriuretic peptide (ANP) may be stimulated by tachycardia and the evidence from human studies suggests that this is mediated by a rise in atrial pressure. However, animal experiments suggest that tachycardia can by itself increase ANP levels without increasing right atrial pressure (RAP). We report here the case of a healthy volunteer who had supraventricular tachycardia (SVT) whilst participating in a study evaluating the relationship between changes in RAP and changes in ANP. The ANP levels rose following the SVT but there was no rise in RAP, suggesting that heart rate can modulate ANP levels without changes in RAP as has been shown in animal experiments.

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00693.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Pyomyositis is a rare purulent infection of skeletal muscle with striking clinical features. It usually occurs in patients living in the tropics but is increasingly being reported in immunosuppressed patients. The traditional approach to management has been surgical with drainage and debridement of the multiple muscle abscesses. We report a patient with myeloma who developed multiple muscle and lung abscesses associated with aStaphylococcus aureussepticaemia. The case was successfully managed with intravenous antibiotics alone with no recurrence of the abscesses during a later episode of neutropenia. The advantages of avoiding surgical intervention in immunosuppressed and thrombocytopenic patients are obvious.

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00694.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.tb00695.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY