ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb00543.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.tb00544.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.tb00545.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

In Sweden, prophylactic treatment of boys with severe haemophilia has been practised since 1958 in an attempt to convert the disease from a severe to a milder form. The present study population consisted of 60 severe haemophiliacs (52 A, 8 B), aged 3–32 years. Treatment is started when the boys are 1–2 years of age, the regimens used being 24–40 IU F VIII kg−1three times weekly in haemophilia‐A cases (i.e.>2000 IU kg−1annually) and 25–40 IU F IX kg−1twice weekly in haemophilia‐B cases. The orthopaedic and radiological joint scores (maximum scores of 90 and 78, respectively) are evaluated as recommended by the World Federation of Haemophilia. Of those subjects aged 3–17 years, 29 out of 35 individuals had joint scores of zero. The oldest group had only minor joint defects. The VIII:C and IX:C concentrations had usually not fallen below 1% of normal. All 60 patients are able to lead normal lives. In conclusion, it appears to be possible to prevent haemophilic arthropathy by giving effective continuous prophylaxis from an early age, and preventing the VIII:C or IX:C concentration from falling

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb00546.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

We analysed the presence of hepatitis C virus (HCV) antibodies in 566 patients undergoing liver biopsy. While over 20% of the patients were anti‐HCV positive according to elisa, only 13.8% had HCV antibodies when tested with a four‐antigen recombinant immunoblot assay (RIBA 2). At the time of inclusion in the study, most patients were asymptomatic, irrespective of whether they were HCV‐positive. Histological findings in anti‐HCV‐positive patients were chronic persistent hepatitis, chronic active hepatitis or cirrhosis in>75% of cases. Only four of the patients who were anti‐HCV‐positive according to the RIBA 2 had autoimmune chronic active hepatitis. Risk behaviour could be identified in the majority of cases. Community‐acquired sporadic cases were rare (12%). Of the 153 patients who died during follow‐up, 23 subjects were anti‐HCV positive. Although age‐ and sex‐adjusted survival was not shorter in anti‐HCV‐positive patients than in anti‐HCV‐negatives, the risk of hepatocellular cancer was higher (P= 0.01). We conclude that HCV infection is associated with chronic liver disease, even when critical evidence of viral aetiology is slight. Truly sporadic cases are rare. Patients infected with HCV are at increased risk of d

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb00547.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The relationship between high‐density‐lipoprotein (HDL) particle size subclasses and the levels of the major lipoprotein lipids was studied in 74 men consecutively referred to the lipid clinic. HDL (density 1.070‐1.21 kg l−1) was separated by polyacrylamide gradient gel electrophoresis (GGE) into five size‐defined subclasses, in order of decreasing size as follows: HDL2b, HDL2a, HDL3a, HDL3band HDL3c. Cholesterol and triglyceride concentrations in very‐low‐density (VLDL), low‐density (LDL) and high‐density (HDL) lipoproteins were determined. The level of VLDL triglycerides was negatively correlated with HDL2b(r= − 0.66.P<0.0001), and positively correlated with HDL3bconcentrations (r= 0.65,P<0.0001). Both correlations were restricted to subjects with VLDL triglyceride concentrations of<1.80 mmol l−1, i.e. those with normotriglyceridaemia. Patients with a history of myocardial infarction and/or angina pectoris (n= 18) had significantly lower HDL2blevels than subjects with asymptomatic hyperlipidaemia (n= 50), i.e. 0.16 vs. 0.22 mg protein ml−1(P<0.05), despite essentially similar cholesterol and triglyceride levels in the VLDL, LDL and HDL fractions, including

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb00548.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The objective of this study was to assess whether a 10‐d treatment with oral theophylline improves the working capacity in patients with ischaemic heart disease, and to compare theophylline with conventional anti‐anginal therapy. Twenty‐four patients with stable effort‐induced angina were included in the study. The patients received double‐blind treatment in randomized order during 4 consecutive 10‐d periods, separated by a 4‐d wash‐out period, with (a) metoprolol durules 200 mg once daily + theophylline durules 300 mg b.i.d., (b) theophylline + placebo, (c) metoprolol + placebo, and (d) placebo alone. At the end of each period a supine exercise stress test was performed. Maximal workload increased to 111 ± 6W during treatment with theophylline, compared to 106 ± 6 W during placebo treatment (P= 0.01). Metoprolol increased the maximal workload to 117 ± 6 W (P<0.001). The effects of metoprolol and theophylline were additive, and the working capacity increased to 123 ± 7 W during combined therapy. Neither the degree of ST‐depression nor the scoring of chest pain at maximal workload differed between the four treatment regimens. An improved working capacity was shown in patients with stable effort‐induced angina pectoris during long‐term theophylline treatment. The effect was additive

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb00549.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Experimental studiesin vitroindicate that insulin‐like growth factor 1 (IGF‐1) could be of importance for normal bone growth and remodelling, but the clinical relevance of these observations is unknown. In 12 consecutive young to middle‐aged male patients (mean age (±SD) 46 ± 8 years, range 30–57 years) with symptomatic idiopathic osteoporosis, the plasma concentrations of IGF‐1 were significantly lower than in healthy subjects (0.51 ± 0.25 vs. 0.73 ± 0.23 U ml−1;P<0.01). The bone mineral densities in the spine, the femoral neck, and the forearm were significantly different between patients and control subjects. There were positive correlations between the plasma IGF‐1 concentrations and the bone densities of the spine and the forearm. Three of the patients received a 5‐d course of human recombinant growth hormone (GH). During this short period significant increases in plasma IGF‐1 levels and in biochemical indices of bone turnover (serum bone‐specific alkaline phosphatase, urinary calcium excretion) were recorded. These observations indicate that circulating IGF‐1 could have an important role in maintaining bone mass, and suggest that impairment of IGF‐1 production is involved in the p

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb00550.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Autonomic nervous function was evaluated in 36 patients with insulin‐dependent diabetes mellitus (IDDM), 39 patients with non‐insulin‐dependent diabetes mellitus (NIDDM) and 48 control subjects, all without clinically evident cardiovascular disease. Valsalva ratio and heart rate variation during deep breathing were lower in both diabetic groups than in the control group. Autonomic nervous function score (ANFS) was more abnormal in patients with IDDM than in control subjects, but was not significantly increased in patients with NIDDM. There was a negative correlation between ANFS and left ventricular diastolic filling evaluated by echocardiography or peak heart rate during exercise in both diabetic groups. There were no correlations between ANFS and left ventricular systolic function at rest or during exercise in any of the groups. In conclusion, autonomic nervous function was abnormal in middle‐aged diabetic patients, and it was associated with impaired left ventricular diastolic filling at rest and decreased heart rate response to exercise, but not with left ventricular systolic f

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb00551.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

In order to study the function of the intestinal epithelium in the terminal ileum, the Schilling test was performed in 10 patients withYersinia‐triggered reactive arthritis, in 10 patients who had recovered fromYersiniaenteritis without complications, and in five patients with rheumatoid arthritis treated with non‐steroidal anti‐inflammatory agents. The Schilling test indicates absorption of vitamin B12in the terminal ileum, i.e. the area affected byYersiniaand inflamed in patients with reactive arthritis. The findings obtained demonstrate increased uptake through the epithelium in this area of the intestine in patients withYersinia‐triggered reactive arthritis. There are two possible explanations. First,Yersiniainfection may have a long‐term effect on the gut mucosa. Secondly, some individuals may, at the level of the terminal ileum, show enhanced absorption of vitamin B12and/or other substances such as microbes or their components, resulting in increased susceptibility to certain i

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1992.tb00552.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY