ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00218.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00219.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.A sample of 120 insulin‐treated diabetics, 20‐40 years of age, with a glomerular filtration rate (GFR) exceeding −2 SD of the age‐adjusted value and without albuminuria>300 mg 24 h−1, and with a diastolic blood pressure not>90 mmHg, were studied in order to evaluate the possible effect of smoking on glomerular filtration rate. The patients reported their smoking habits, use of oral snuff, use of alcohol, physical exercise and heredity for hypertension in a simple questionnaire. GFR was assessed with51Cr‐EDTA‐clearance and glomerular hyperfiltration was defined as a value exceeding + 2 SD of the age‐adjusted normal value. We found a significantly higher prevalence of glomerular hyperfiltration in smokers than in non‐smokers (41% vs. 18%), but no increased prevalence in users of oral snuff. In cigarette smokers a multivariate analysis revealed that GFR was positively related to body mass index (BMI), and negatively related to the number of cigarettes smoked per week and the mean blood pressure. In non‐smokers GFR was dependent only on age. We conclude that in insulin‐treated diabetics glomerular hyperfiltration is related to smoking, and that the GFR in smoking diabetics is directly dependent on the smoke doses. As glomerular hyperfiltration is regarded as a risk factor for diabetic nephropathy, our findings should be relevant to preventive meas

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00220.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.A double‐blind multicentre study of 349 hypertensive patients was performed to compare the side‐effects of the two beta‐blockers atenolol (selective beta1‐blocker) and pindolol (beta1‐ and beta2‐blocker with Intrinsic sympathomimetic activity (ISA)) in equipotential doses (100 mg atenolol vs. 15 mg pindolol). Male and female patients aged 20‐65 years with essential hypertension WHO stages I and II were included. Patients were examined 1 and 6 months after the start of treatment, and side‐effects were recorded. The antihypertensive effect was similar for the two drugs. After 1 month there was significantly less bradycardia (P<0.01), cold hands and feet (P<0.05) and tiredness (P<0.02) in the pindolol group, and less sleep disturbance (P<0.02) in the atenolol group. After 6 months there was no significant difference in sleep disturbance, but the differences in the other side‐effects rem

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00221.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.A hyperventilation provocation test (HVPT) was performed on a group (n= 63) of consecutive patients, below the age of 40 years, attending an emergency care unit complaining of chest pain without obvious organic cause. The results were compared with those for a control group (n= 32). There was no tendency to hyperventilate in the patient group, either after discontinuing hyperventilation or during the ensuing relaxation period. PETCO2measurements during this time thus showed no significant differences between the patient group and the control group. During the HVPT, 44% of patients reported three or more listed symptoms familiar to them from earlier occasions and regarded as typical of hyperventilation, compared to 23% of the controls (P<0.05). In a previously reported study, 38% of the patients were found to have similar symptoms during standardized mental stress, despite lack of hypocapnia. It is concluded that, on the basis of PETCO2measurements, there were no signs of abnormal hyperventilation in the patient group. Moreover, the HVPT did not appear to be specific for diagnosis of hyperventilation syndrome, since mental stress itself was able to reproduce symptoms without concomitant hypocapnia, and since the provocation test was ‘positive’ in many control subje

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00222.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.In 1985 one of the new sensitive thyroid stimulating hormone (TSH) assays was introduced as part of our laboratory routine for thyroid function testing. Consequently, we now routinely identify a small but not insignificant group of patients with ‘subclinical thyrotoxicosis’, i.e. a low serum TSH in conjunction with a normal serum free T4. We here present the results of a 2‐year follow‐up investigation, which includes 40 patients with subclinical thyrotoxicosis and 40 euthyroid control patients. The group with subclinical thyrotoxicosis was characterized by a mean age of 65 years and a high prevalence of nodular goitre. Twelve (30%) of the patients but none of the individuals in the control group were treated during the follow‐up period because of clinical thyroid disease. Atrial fibrillation was found in 11 (28%) patients compared to four (10%) of the controls. Therapy should be considered more often than previously in patients with nodular goitre and subclinical thyrotoxicosis, particularly in conjunction with atrial fib

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00223.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Serum levels of magnesium (s‐Mg), calcium (s‐Ca), potassium (s‐K) and sodium (s‐Na) were measured in 80 women with primary Raynaud's phenomenon (RP) and in 24 age‐matched female controls recruited from a population survey. The blood samples were taken after a 40‐min standardized whole body cooling test. The mean s‐Mg level in the group with RP was significantly lower than in the controls (0.81 ± 0.05 vs. 0.86 ± 0.07 mmol l−1,P<0.05). One year later, 66 members of the RP group and 22 members of the control group were investigated further, but without any exposure to cold. No differences in mean s‐Mg values were found between the groups. The mean s‐Mg level was significantly higher in the blood samples taken later without cold exposure than at the initial examinations after exposure to cold in the RP group, but not in the controls. The s‐Mg level was lower after exposure to cold in 82% of the women with RP, compared to 45% of the controls (P<0.001). No differences in the other electrolytes were found. It is concluded that exposure to cold under standardized conditions may decrease the s‐Mg level in women with primary RP. Further studies of the role of magnesium in pati

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00224.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.The efficacy and safety of a new, selective inhibitor of cholesterol synthesis, pravastatin, and the bile acid‐binding resin, cholestyramine, were compared in a randomized, double‐blind study of 120 patients with familial hypercholesterolaemia. After a run‐in period of 8‐10 weeks with assessment of dietary habits, the patients were treated with pravastatin + placebo, placebo + cholestyramine, or placebo alone. Active pravastatin therapy was initiated with 10 mg b.i.d. for 6 weeks, and was increased to 20 mg b.i.d. for the following 6 weeks. Cholestyramine was given at 24 gd−1, or the highest tolerable dose. After 6 weeks of therapy, serum total and LDL cholesterol levels were reduced by 17% and 21%, respectively, on pravastatin treatment, whereas the corresponding reductions with cholestyramine treatment were 24% and 30%, respectively. With an increased dose of pravastatin, serum and LDL cholesterol concentrations were reduced by 23% and 28%, respectively, after 12 weeks; the effect of cholestyramine was unchanged. HDL cholesterol levels increased in response to pravastatin, by 7% and 9% after 6 and 12 weeks, respectively. Concomitant changes in the concentrations of apolipoproteins B and AI were observed. Three patients discontinued the study because of side‐effects: two subjects were treated with pravastatin and one was given placebo. The prevalence of side‐effects (including laboratory abnormalities) was 35% for pravastatin, 30% for placebo, and 53% (significantly higher) for cholestyramine. We conclude that pravastatin, in a 40 mg daily dose, is as effective as cholestyramine in lowering LDL cholesterol in familial hypercholesterolaemia. Since the frequency of side‐effects is higher with cholestyramine, pravastatin offers a promising alternative for the therapy of this

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00225.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.The endothelial cell‐synthesized haemostatic factors tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI) and von Willebrand factor (vWF) were assayed in a cross‐sectional study of patients with immune thrombocytopenia (ITP) (n= 12) and autoimmune haemolytic anaemia (AIHA) (n= 3), and compared with a simultaneously selected contrast group of other hospitalized patients with obscure blood cytopenia at the time of sampling. All three factors were grossly elevated in both the study group and the contrast group. In the autoimmune patient group, the three haemostatic variables were significantly correlated with orosomucoid levels, demonstrating the acute‐phase nature of the increased levels of vWF, tPA and PAI. These findings support the view that haemostatic factors of the vessel wall are implicated in the pathophysiology of a wide spectrum of dis

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00226.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Follow‐up of 270 subjects who declined to participate in a trial of oral anticoagulant therapy after acute myocardial infarction revealed a higher mortality (25.6%) than that for participants in the placebo group (20.2%). The excess mortality in terms of odds ratios was 1.35 (90% confidence interval 1.02‐1.79). Age was the only predictor of death. The event rate from ischaemic cardiovascular disease was lower among non‐consenters than among participants (49.3% vs. 74.8%), as was the rate of death during the first year of follow‐up. In conclusion, the differing mortality and dissimilar patterns of specific causes of death in non‐consenters and placebo‐treated participants emphasize the need for caution in extrapolation of treatment effects to the non‐consenting group. Thus the size of the non‐consenting group has implications for generalization of the

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00227.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY