ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb01241.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract.Aplastic anaemia (AA) has been defined as a syndrome in which the presence of pancytopenia is accompanied by marrow hypocellularity. Ample laboratory data and clinical observations continue to make immune mediation of bone‐marrow failure an attractive hypothesis. Recent progress in the practice of bone‐marrow transplantation has led to a survival rate of approximately 80% in the best cases, but such a treatment is only amenable in young patients (<45–50 years) with HLA‐identical bone‐marrow donors. Anti‐lymphocyte and thymocyte globulin treatment has been surprisingly effective for AA, resulting in transfusion independence in 40–80% of patients. The mechanism of action is unknown, although effects on immunosuppression appear to be the most likely candidates. Long‐term results for patients receiving cyclosporin A treatment will soon be available, and preliminary data show an effect similar to that of antithymocyte globulin. In contrast to successful bone‐marrow transplantation, improvement following immunomodulation leaves quantitative abnormalities in all haematopoietic cell lines, and patients are prone to develop clonal (m

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb01242.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract.As part of a prospective population study in Gothenburg, Sweden, women aged 50 years were subjected to an intravenous glucose tolerance test on entry to the study and followed up for 12 years. Manifest diabetes was the only end‐point registered in this part of the study. Of 352 initially non‐diabetic women, 17 (4.8%) subjects developed diabetes, with a fourfold increased risk in women taking antihypertensive drugs (diuretics or β‐blockers, or both) compared with women who were not taking such medication. The increased risk was observed independently of initially measured glucose metabolism variables and degree of adiposity, although the incidences were higher overall if the use of antihypertensive drugs was combined with fasting hyperinsulinaemia and adiposity. This study provides further evidence to support the view that diuretics and β‐blockers are precipitators of type 2 diabetes

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb01243.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract.The non‐sulfhydryl selective angiotensin‐converting enzyme inhibitor benazepril (20 mg daily) was compared with hydrochlorothiazide (50 mg daily) in post‐infarction (6–24 months) patients with symptomatic (NYHA functional class 2) mild heart failure. No concomitant drug therapy was given. The study had a double‐blind cross‐over design with 3‐month treatment periods. Both drugs were well tolerated, and both caused a similar reduction in systolic blood pressure. Heart rate was higher with the diuretic. Benazepril improved the NYHA functional class in 17 out of 29 (59%) patients, whereas one patient improved with hydrochlorothiazide (P= 0.0004). With regard to global efficacy score, benazepril was also superior. Thus, angiotensin‐converting enzyme inhibitors may be superior to diuretics as first‐choice therapy in symptomatic m

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb01244.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract.The aim of this study was to determine whether platelets are activated and aggregation is increased in myocardial infarction treated with streptokinase. Twelve consecutive patients were studied. Before streptokinase infusion (1.5 times 106IU i.v. over a period of 1 h), 7 ± 4 h after the onset of symptoms, fibrinogen, leucocyte and platelet functions were enhanced compared to reference values. Plasma fibrinogen was 3.1 ± 0.6 g l‐1(P<0.03), leucocyte count was 14.3 ± 3.3 times 103l‐1(P<0.0005), elastase was 39 ± 8 μg l‐1(P<0.0002), β‐thromboglobulin was 68 ± 71 μg l‐1(P<0.0001) and filtragometer platelet aggregation time was 137 ± 40 s (P<0.0001). After streptokinase the leucocyte count, elastase and β‐thromboglobulin levels increased further, by about 40% (P<0.02), 130% (P<0.02) and 140% (P<0.005), respectively. Fibrinogen was almost eliminated. Despite signs of increased activation, platelet aggregation was decreased as indicated by both filtragometer aggregation time, which increased by about 480% (P<0.003), and whole‐blood aggregometry, in which electrical impedance decrease

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb01245.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract.Seventeen haemodialysis patients with renal anaemia were treated with recombinant human erythropoietin (rhEPO) and observed for 30 weeks. The viscosity of whole blood and plasma, the erythrocyte aggregation tendency, and the erythrocyte deformability, measured as fluidity, were analysed every second week. All patients responded with increasing haematocrit and whole‐blood viscosity. The plasma viscosity and the erythrocyte aggregation tendency were already increased before the start of treatment, and remained unchanged during treatment. The basal erythrocyte fluidity tended to be impaired, although not significantly so. During treatment, significant impairment of fluidity was observed at the beginning of the treatment period. After 24 weeks the fluidity started to increase, and it later reached values observed before the start of treatment. Hence, the quality of the erythrocytes formed during the corrective phase of rhEPO treatment differs in some respects from that of cells formed at a normal production rate. The impaired fluidity might have important implications for the flow resistance in small vessels, and contribute to the development or aggravation of hypertension that is often seen during rhEPO treatmen

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb01246.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract.The safety and clinical impact of isoprinosine in HIV‐infected individuals were assessed in a multicentre, randomized, double‐blind, 24‐week study phase, followed by an optional 24‐week open treatment phase, The results of the double‐blind phase have been reported. Of 866 HIV‐seropositive patients randomized, 832 subjects were eligible for efficacy analysis. On completion of the double‐blind phase, 596 patients started open treatment. All patients were evaluated with regard to progression to AIDS and/or death. Within 48 weeks, 10/412 (2.4%) patients assigned isoprinosine and 27/420 (6.4%) patients assigned placebo progressed to AIDS (P= 0.005). Intention‐to‐treat analysis showed identical results. Viewing the open treatment phase in isolation revealed no difference in progression rates between those treated and those not receiving the drug, perhaps reflecting the higher proportion of patients receiving zidovudine or PCP prophylaxis in the latter group. No severe adverse reactions or toxicities were observed. We conclude that HIV‐seropositive patients without AIDS may be safely and effectively treate

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb01247.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract.The presence of autoantibodies against factor VIII is an unusual but serious complication in rheumatoid arthritis. We describe the case of a patient who developed this kind of complication, with spontaneous bleeding and marked changes in the haematological parameters, that was unsuccessfully treated with a high dose of intravenous gammaglobulin. Subsequently, combined therapy with porcine factor VIII concentrate, cyclophosphamide and steroids led to the disappearance of the anti‐factor VIII autoantibodie

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb01248.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract.The case of a married couple who simultaneously developed polymyalgia rheumatica is presented. Both patients responded to steroid treatment, and when the steroid dose was gradually reduced both patients relapsed. The aetiology and pathogenesis of polymyalgia rheumatica remain unclear; familial aggregation indicates the involvement of genetic factors, whereas conjugal aggregation indicates infectious/environmental agents. In previous reports of polymyalgia rheumatica in married couples, the onset of symptoms in the two patients has usually been separated by a long chronological interval. It is concluded that the present report of simultaneous development of polymyalgia rheumatica in a married couple lends further support to an environmental or contagious aetiology.

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb01249.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb01250.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY