ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00109.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.In order to predict the outcome of patients with acute neurological symptoms at discharge, the concentration of creatine kinase isoenzyme BB (CK‐BB) was determined by radioimmunoassay in the cerebrospinal fluid (CSF) of 115 consecutive patients. On admission and over the next 3 days the concentration of CK‐BB was significantly increased in patients with brain death and other neurological sequelae compared with those with favourable outcome. There was a variation in time in concentrations of CK‐BB between diseases causing neurological sequelae. Thus, cerebrovascular haemorrhages caused highest concentrations on admission, but cerebral ischaemia due to cardiac arrest caused highest concentrations 3 days after admission. On admission the CK‐BB measurements were highly specific with high predictive value of positive result when distinguishing patients with brain death and other neurological sequelae from those without complications at discharge. However, when distinguishing patients with brain death from those with other neurological sequelae, the test was most specific and had highest predictive value of a positive result 3 days after ad

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00110.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.The study was performed on patients with ischaemic cerebral infarction in order to obtain information on serial changes of some platelet parameters and to test their prognostic significance.Platelet count, obtained within 48 h after cerebral infarction, was significantly lower than in the control group (213611±65652 mm−3vs. 299525±60611 mm−3,P<0.001), reaching the normal level on the ninth day and thereafter. The mean platelet volume was significantly greater than in the controls (11.26±1.29 flvs. 8.93±0.93 fl.P<0.001), and normalization generally occurred on the forty‐fifth day.The mean platelet count was significantly lower in the patients who died than in those who survived (P<0.025 andP<0.05 respectively on the first to second and fourth day after infarction).The reduction of platelet count and the increase of mean volume appear to be related to an increased platelet consumption in the infarction area, associated with anin vivoplatelet activation, as larger platelets are more responsive to platelet activity and aggregability tests.The lower mean platelet count observed in the patients who died suggests that the platelet value might be considered as a prognostic index of cerebral i

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00111.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Effects of in‐hospital resuscitations performed by a trained resuscitation team were studied over a 20‐month period during which 1653 deaths were registered. Resuscitative attempts were made in 61 patients with a mean age of 71 years (range 0–86 years). The underlying disease was ischaemic heart disease in 38 cases and most arrests occurred in general wards. Twenty‐one patients were initially resuscitated; 12, however, died after an average of 3.2 days while still in hospital. Nine patients were discharged and seven are still alive after two and a hal

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00112.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Haemodilution is often recommended for peripheral arterial disease, yet little data is available to support its clinical efficacy. This study was designed to prove or disprove the effectiveness of Dextran‐haemodilution in intermittent claudication. Twenty claudicants with long, well‐collateralized arterial occlusions were randomized into groups 1 and 2. Group 1 received isovolemic haemodilution with Dextran 40 (500 ml per session) during 3 weeks, which was followed by a wash‐out period, followed by placebo treatments for 3 weeks. In group 2 this sequence was reversed. Pain‐free and maximal walking distances were measured by standardized treadmill tests along with plethysmographic blood flow, Doppler pressures, haematocrit, blood and plasma viscosity as well as fibrinogen. Walking distances increased significantly by about 50% during haemodilution in both groups. This was paralleled by a fall in haematocrit and blood viscosity. All other variables remained constant. During placebo treatments there were no significant changes of any variable. The treatment was tolerated without complications. Thus Dextran‐haemodilution seems safe and effective in selected peripheral occlusive arterial disease (POAD) patients. Potential responders might be identifiable before the start of therapy by angiographic investigations. The clinical effectiveness of Dextran 40 is comparable to that of hydroxyaethyl starch 200 as reported in the l

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00113.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 acupuncture in moderate, stable angina pectoris, 49 patients were randomized to either genuine or sham acupuncture. In sham acupuncture needles were inserted into points within the same spinal segment as in genuine acupuncture, but outside the Chinese meridian system. The effect was evaluated from exercise tests, anginal attack rate and nitroglycerin consumption. There were no significant differences between the effects of genuine and sham acupuncture either on exercise test variables or on subjective variables. In patients receiving genuine acupuncture there was a significant increase in exercise tolerance (median 9%) and in delay of onset to pain (median 10%). No significant changes were observed in patients receiving sham acupuncture. Within both groups there was a median reduction of 50% in anginal attack rate and nitroglycerin consumption, and there was no significant difference between the results achieved in the two groups. It is concluded that with the present design it was not possible to demonstrate any significant differences between the effect of genuine and sham acupuncture.

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00114.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Job strain, a high level of psychological demands combined with a low level of decision latitude, has been hypothesized to induce mobilization of energy and inhibition of anabolism. In the present project this hypothesis was tested using four repeated observations every third month in a group of 44 men working in six widely different occupations. On each occasion scores of self‐reported demands and decision latitude were calculated for every participant. An earlier report has shown that systolic blood pressure during work hours ‐ an indicator of mobilization of energy ‐ increased with increasing job strain (ratio between demands and decision latitude). Blood samples were drawn in the morning at the work site. For each man the plasma testosterone levels ‐ representing the general level of anabolic activity ‐ on the two occasions with the worst strain (ratio between demands and decision latitude) were compared with the plasma testosterone levels on the two occasions with the least strain. The results indicated that total plasma testosterone (but not free testosterone) levels increased when strain diminished in sedentary but not in physically demanding work. Subjects with a family history of hypertension showed a greater decrease in testosterone levels than others when job strain

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00115.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.In a double‐blind, randomized, cross‐over study with a single‐blind placebo run‐in period a new controlled‐release (CR) formulation of metoprolol 200 mg once daily was compared with atenolol tablets 100 mg once daily in 22 patients (age 60.9 ± 0.93 (SE) years) with primary hypertension and impaired or diabetic glucose tolerance. Each period lasted for three weeks.The two agents produced similar blood pressure 3 h as well as 24 h after drug intake. Three hours after drug intake, heart rate was lower on atenolol than metoprolol CR treatment, indicating a higher degree of β‐receptor blockade for atenolol at this point in time, when the plasma concentration of atenolol was most likely to be close to its peak.Concentrations of blood glucose, serum insulin, and serum C‐peptide in the fasting state or after an oral glucose load did not differ between the active agents. HbA1cwas marginally, but significantly, lower on atenolol than metoprolol CR treatment. No differences were found in serum levels of total, low density lipoprotein (LDL), and high density lipoprotein (HDL) cholesterol or apoA‐I, and apoB lipoproteins or triglycerides. In comparison to the placebo run‐in period, both agents showed an unexpected improvement in glucose tolerance, a decrease in HDL cholesterol and for metoprolol CR a small, but significant decrease in LDL cholesterol.Thus, treatment with metoprolol CR tablets producing even plasma levels without high peak concentrations and conventional atenolol treatment had similar effects on metabolic control in hypertensive men and abnorma

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00116.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.The antitumour effect of recombinant human interferon (rh‐IFN) alpha‐2b was studied in 22 patients with advanced multiple myeloma (MM). Nine of 14 evaluable cases were refractory to cytostatic therapy; five were in relapse. rh‐IFN was administered s.c. three times per week, in escalating doses starting with 2 times 106IU m−2and if possible up to 15 times 106IU m−2. Two patients (one refractory, one relapsing) showed a partial response, defined as a 50% reduction of the serum M‐component. Three further patients had a minor, significant but short‐lived response. Subjective side‐effects grade 1–2 were noted during rh‐IFN therapy in all patients. In three cases thrombocytopenia necessitating platelet transfusions occurred. Although a fraction of patients with advanced MM obviously respond to rh‐IFN, this type of therapy may be more effective, alone or in addition to chemotherapy, in patients with a l

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00117.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.In the county of Klaksvik, the Faroes, a simple hand test was used for screening all inhabitants between the ages of 40 and 74 years. With its high sensitivity and specificity it revealed a diagnostic panorama entirely different from that seen in previous investigations in other nordic countries.In Klaksvik the prevalence of hand handicap was about 40%, which is due to the high incidence of osteoarthrosis. The prevalence of rheumatoid arthritis was 1.1%. The high functional capacity and the lower occurrence of rheumatic nodules and erosions found in the patients with rheumatoid arthritis as compared with previous studies suggest that the disease takes a milder course in Klaksvik. This should support the hypothesis that RA patients benefit from a diet rich in fish.

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00118.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY