ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00135.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Plasma lipid and lipoprotein concentrations were monitored in 16 patients with acute malaria. Plasma high density lipoprotein (HDL) levels decreased dramatically during the first 3 d after diagnosis to around 0.2 mmol l‐1(reference range 0.8–1.6 mmol l‐1). The low HDL levels were related to parasitaemia, and rapidly recovered after successful therapy. Plasma triglyceride concentrations were moderately increased and plasma low density lipoprotein (LDL) cholesterol concentrations decreased during the course of infection. The mechanisms underlying the selective and pronounced decline in HDL cholesterol concentration remain obscure, but the reproducible phenomenon may be useful as an additional diagnostic tool in suspected malaria infe

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00136.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.The blood pressure (BP) response during a maximal ergometer bicycle test was studied in 190 apparently healthy subjects (95 men and 95 women) aged 21–70 years. The starting load was 50 W and was increased by 50 W every 4 min until exhaustion. Mean physical performance expressed as cumulative work was 2276±789 W in men and 1109±276 W in women (P<0.0001). The maximum heart rate was similar in men and women and declined significantly with age (r = − 0.78,P<0.001 for men and r = − 0.64,P<0.0001 for women). The mean maximal systolic blood pressure (MSBP) was 193±23 mmHg in men and 171±21 mmHg in women (P<0.0001). Men aged ≥ 50 years had a MSBP of 201±22 mmHg, compared to 188±22 mmHg in those aged<50 years (P<0.01). Women aged ≥ 60 years had a MSBP of 190±21 mmHg compared to 166±19 mmHg in their younger counterparts (P<0.001). The diastolic BP showed a similar modest increase at all ages and in both sexes.SBP is dependent on age and gender and this must be taken into consideration when assessing a normal response in in

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00137.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.In a prospective study of 278 consecutive patients admitted to an emergency ward for chest pain, the 115 clinical and paraclinical parameters available at the time of admission were evaluated by computer comparison with the final diagnoses. The most valuable items for making the diagnosis were classified according to their sensitivity, specificity and predictive value. Among the 278 patients, 100 individuals had myocardial infarctions (MI), 47 had unstable angina, 25 had stable angina and 106 patients had a non‐coronary disease.The twelve mostsensitiveitems for distinguishing MI from other conditions were the following: sudden onset of pain (70%): duration of more than 60 min (88%): constriction and squeezing (79%): oppression (75%): prior anginal attacks (61%): sex male (72%): age over 60 years (74%): abnormal heart auscultation (62%): abnormal electrocardiogram (ECG)(98%): segment (ST) disturbances (86%): increased glucose level (77%): CKMB fraction greater than 6% of total creatine kinase (CK) level (63%).Among the twelve mostspecificitems, also with the best positive predictive value, irradiation in the right arm is of most importance: among the 51 patients with right arm involvement, 48 suffered from a coronary disease and 41 from a myocardial infarction. The largest extension of pain was reported in the latter group.It is concluded that chest pain with a wide irradiation involving the right arm strongly suggests that a myocardial infarction is ongoin

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00138.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Obese women (n= 104) were treated with an energy reduced diet (1100 kcal d−1) in a strictly standardized outpatient regime. Body composition, regional adipose tissue distribution, regional fat cell sizes and metabolic variables were followed before treatment, after 5% weight loss and at the stage when there was no further weight loss. Premenopausal women lost less body fat and relapsed earlier after treatment, compared with menopausal women. Fat loss appeared to be more uniform, and included several adipose tissue regions in postmenopausal women, while younger women seemed to lose fat mainly from the epigastrial fat cells. Higher baseline levels of thyroid hormones were associated with increased fat loss and a tendency to lose less lean body mass. Waist/hip and waist/thigh ratios did not change in response to weight loss. The addition of fibre to the diet did not affect the rate of relapse.These results suggest that obesity treatment by implementation of a negative calorie balance might be more successful in postmenopausal than in younger women, perhaps due to the more uniform availability of body fat in the forme

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00139.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.A possible role of the proopiomelanocortin derived peptideγ2–melanocyte stimulating hormone (γ2‐MSH) has been studied in patients with various degrees of congestive heart failure (CHF). The profile of changes in circulating levels ofγ2‐MSH‐like immunoreactivity (‐LI) has been compared with those of atrial natriuretic peptide (ANP)‐LI, arginine vasopressin (AVP)‐LI and catecholamines in CHF. Patients with moderate CHF (New York Heart Association stages I‐II) showed significantly higher levels of h‐αANP‐LI and NA (P<0.05) compared to controls. Patients with severe CHF (stages III‐IV) had significantly higher levels of all hormones measured compared to controls: noradrenaline.P<0.001: adrenaline,P<0.001:γ2‐MSH‐LI,P<0.001: h‐αANP‐LI,P<0.05: AVP‐LI,P<0.01. For the catecholamines andγ2‐MSH‐LI there was a significant increase from moderate to severe forms of CHF. A significant correlation was observed betweenγ2‐MSH‐LI and noradrenaline, and between h‐αANP‐LI and noradrenaline in patients with CHF. The present results show thatγ2‐MSH‐LI is increased only in severe forms of cardiac failure, and that this change is more closely related to the increase in circulating levels of n

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00140.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Thromboxane B2(TXB2) levels in bleeding time blood and in serum were measured in 13 elderly patients with cardiovascular disease, seven of whom were receiving continuous treatment with low dose acetylsalicylic acid (ASA, 125 mg every second day — 250 mg daily) for prevention of stroke. Blood sampling was performed openly, but assays of TXB2were performed by a blinded investigator. In patients treated with ASA, median serum TXB2‐levels were 4% and TXB2‐levels in bleeding‐time blood were<16% of the corresponding levels in patients without ASA (P<0.01). The results show that in elderly atherosclerotic patients very low doses of ASA substantially suppress TXB2formation, not only in serum but also at the site of local haemostasis. The extent of suppression is comparable to that previously reported from young healthy s

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00141.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.We have studied 773 consecutive cases (706 individuals) with definite myocardial infarction treated in the Coronary Care Unit at Danderyd Hospital in Stockholm during the period 1984–85. Hospital mortality was 12.9% in all patients and 8.9% in patients under 70 years of age. Six hundred and six patients were discharged from the hospital and followed up for 2 years. The 2‐year mortality in ischaemic heart disease was 14.4% in all patients and 9.5% in patients under 70 years of age and, including all causes of death, 20.3% and 14.6%, respectively. Our policy for medical treatment included frequent use of beta‐adrenergic blocking agents, even in heart failure, and restricted use of antiarrhythmic drugs and digitalis. A short delay of admission may have been beneficial for the result of different kinds of anti‐ischaemic intervention. Furthermore, a routinely performed exercise ECG before discharge and after 6 weeks, as part of a structured follow‐up, has improved our ability to detect complications at an early stage and to optimize medical

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00142.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Kinetics of very low density lipoprotein (VLDL) triglyceride were determined in seven patients with heterozygous familial hypercholesterolaemia, using a3H‐glycerol technique. The study was repeated after 5–7 weeks of therapy with the bile acid‐binding resin, cholestyramine. The rate of synthesis of VLDL triglyceride was increased by 85% (P<0.05) during resin therapy. Simultaneously, the fractional catabolic rate of VLDL was increased by 40% (P<0.02), so that only a moderate increase in plasma concentration was observed.Repeated measurements of VLDL size by electron microscopy (before, 1 week, and 5–7 weeks after initiation of therapy) indicated that a transient increase in VLDL size occurred in response to cholestyramine.The results are consistent with a stimulatory effect of bile acid sequestrants on VLDL triglyceride production and indicate that, in most subjects, a compensatory increase in VLDL triglyceride removal

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00143.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Interferon‐α (IFN‐α) is currently used in the treatment of various malignant tumours. Development of different autoimmune disorders has been reported in some patients during IFN‐α therapy. Systemic lupus erythematosus (SLE) after treatment with IFN‐α has not been described, although a majority of SLE patients have demonstrable serum levels of IFN‐α, which correlate with disease activity and have been suggested to be of pathogenetic significance.In this paper we describe a patient with a malignant carcinoid tumour who developed a SLE‐like syndrome during treatment with leucocyte IFN‐α. The patient developed myalgia and low grade arthritis in multiple joints together with a high titre of antinuclear antibodies (ANA) and anti‐dsDNA antibodies. After the treatment was stopped, the symptoms subsided although a moderate ANA titre persisted. However, the tumour continued to regress despite cessation of IFN‐α therapy. During a short course with recominant IFN‐α the syndrome relapsed, supporting the concept that the SLE syndrome was precipitated by IFN‐α. A connection between IFN‐α treatment, the induced autoimmune disorder and regression of

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00144.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY