ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00197.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.tb00198.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Three hundred and thirty‐three consecutive patients in a medical ward were evaluated in a high‐intensity monitoring scheme for drug events as a cause of hospitalization. Taking into consideration only ‘definite’ and ‘probable’ drug events, we found 36 cases (10.8%) of all admissions to be drug‐related hospitalizations (DRH). Of these, 8.1% were adverse drug reactions and 2.7% were therapeutic failures due to ineffective dosage. In 8 cases (2.4%) the drug event could definitely have been avoided, and a further 13 cases (3.9%) were considered to have been potentially avoidable if appropriate measures had been taken by the health service. In 19 cases (53%) the referring physician was unaware of the drug‐related problem. Those patients admitted because of a drug event were taking significantly more drugs than other individuals. The avoidable drug events pointed to the primary health care physicians as the appropriate targets for preventive measures in terms of intensified drug education.The study demonstrated that a reliable estimate of the DRH rate requires active data collection by a qualified health service worker in close collaboration with the patient's family doctor in cases o

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00199.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.To investigate whether leukotriene B4 is present in the arterial blood of asthmatic patients during wheezing attacks. 20 ml of arterial blood was drawn from the inguinal artery of five patients. Leukotriene B4 was detected in all five individuals, and its identity was confirmed by a combination of high pressure liquid chromatography and radioimmunoassay techniques. The concentration of leukotriene B4 was 48.34 ± 16.27 pg ml−1(mean value ± SE). However, in five control subjects the leukotriene B4 concentration was found to be 9.43 ± 5.44 pg ml−1. Thus there was a significant difference between the two groups (P<0.05). These results suggest that leukotriene B4 may be important in elucidation of the pathogenesis of bronchial

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00200.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.To evaluate the predictive capability of the postprandial blood glucose response after consumption of a starch‐rich meal, we compared the glycaemic effects of spaghetti (60 g) taken alone and with bolognese sauce (167 g). The study was carried out in both NIDDM (n= 6) and IDDM (n= 6) subjects. The latter had achieved normoglycaemia 120 min prior to the test meal by means of an artificial pancreas (Biostator®) which provided constant insulinaemia during the observation period of 4 h. We found that the areas of blood glucose (above basal) were identical irrespective of whether spaghetti was taken alone or as part of a mixed meal in both NIDDM (484 ± 1 54 mmol l−1240 min−1vs. 393 ± 126 mmol l−1240 min−1) and IDDM subjects (6.10 ± 143 mmol l−1240 min−1vs. 770 ± 135 mmol l−1240 min−1). The insulin levels were identical in the IDDM diabetics. By contrast, the mixed meal caused a more marked insulinaemic response than spaghetti per se in the NIDDM subjects (3187 ± 637 mU l−1240 min−1vs. 1940 ± 235 mU l−1240 min−1;P<0.05). In conclusion, the predictive capability of the glycaemic response to spaghetti was good in both IDDM and NIDDM diabetic subjects, at least under the

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00201.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.A prospective study has been performed on 84 patients with endocrine pancreatic tumours evaluated at the Medical Department in Uppsala. Available information concerning the patients' presenting symptoms, age at diagnosis, clinical syndrome, tumour location, location of metastases, diagnostic radiology, biochemical and histopathological findings has been analysed. Our results indicate that most patients initially show rather vague and non‐specific symptoms, with dyspepsia and pain being the most frequent presenting features. The median delay between appearance of the first symptom and diagnosis was 2 years; the delay was 3 5 months in sporadic cases and 14.5 months in familial cases. In spite of improvements in diagnostic methods, the median age at diagnosis (53 years) has not been reduced, and most patients are encountered when the tumour has reached an advanced stage. There is a need for a method of screening patients with still uncharacteristic abdominalsymptoms for a neuroendocrine tumour. The presence of elevated levels of plasma chromogranin in all patients with a proven tumour suggests that such possibilities exist, and the use of this biochemical marker in the future might reduce the age at diagnosis and thus improve the likelihood of cure and survival of patients with endocrine pancreatic tumour

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00202.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Data from a prospective epidemiological study that included 2025 plain cigarette smokers were analysed to investigate the effect on phlegm production of changing to filter cigarettes or quitting smoking. During a 5‐year follow‐up, 189 subjects quitted smoking, 312 changed to filter cigarettes, while 1524 continued to smoke plain cigarettes. Multiple logistic regression was used to adjust for age, duration of smoking, number of cigarettes smoked, socio‐economic status and alcohol consumption. Smokers with morning phlegm at enrolment, who changed to filter cigarettes during the follow‐up, had a probability ratio of 1.9 of phlegm production ceasing, compared with smokers who continued to smoke plain cigarettes (P<0.05). However, the probability ratio of developing morning phlegm among smokers who changed to filter cigarettes compared to those who continued to smoke plain cigarettes was 1.6 (P<0.05). The overall prevalence of morning phlegm at the end of the follow‐up was the same in smokers who changed to filter cigarettes as in persistent plain cigarette smokers. The trends for chronic phlegm were similar, although they did not reach statistical significance. The smokers who stopped smoking had a probability ratio of 0.4 of developing morning phlegm (P<0.01) and a ratio of 7.7 for ceasing to produce it (P<0.001) compared to the smokers who continued to smoke plain cigarettes. Our results suggest that changing from plain to filter cigarettes is associated with a higher frequency of cessation of phlegm production, but offers no protection against the development

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00203.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Thirty‐four consecutive patients with diabetes mellitus as a plausible cause of end‐stage renal failure were investigated with regard to outcome and tobacco consumption. The mean duration of diabetes was 25.5 years. Thirty‐one of the patients had used tobacco regularly for at least 5 years. For 28 patients it was possible to calculate the intake of tobacco as the daily mean and the total consumption (expressed as pack years). The time period (in years) between initiation of tobacco usage and onset of persistent proteinuria, as an early indicator of diabetic nephropathy, was shorter if the daily consumption of tobacco was higher (P<0.01) and the total consumption (pack years) in these patients was lower (P<0.05). There was an increased risk of early death (P<0.01) in patients who were currently smokers when they were uraemic (predialysis), on dialysis or had kidney grafts, compared to those who had never used tobacco or who were ex‐smokers. In conclusion, it appears to be important for insulin‐dependent diabetic patients to avoid tobacco usage and for current smokers to give up the habit in order to reduce the risk of diabetic nephropathy and ea

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00204.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.From a large randomized multicentre trial of metoprolol in suspected acute myocardial infarction (n= 5778) we report on the outcome during 1 year of follow‐up, in relation to early diagnosis. Patients who developed a confirmed infarction had a 1‐year mortality rate of 12.8%. This was significantly higher than the mortality rate of 6.3% (P<0.001) in patients with possible infarction and it was also higher than that in patients with no infarction, which was 5.0% (P<0.001). A multivariate analysis showed that independent risk predictors in the clinical history of patients without confirmed infarction were a history of angina pectoris, chronic use of digitalis and advanced age. After 1 year, angina pectoris was most common in patients with an initial possible infarction. These patients were also in most urgent need of bypass surgery. We thus conclude that the mortality during 1 year of follow‐up among patients with an initially strongly suspected acute myocardial infarction was clearly related to whether or not the patient developed a myocardial infar

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00205.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Twenty‐three patients with treated malignant hypertension (MH), 23 patients with treated non‐malignant hypertension (NMH) and 46 normotensive control subjects were investigated with regard to intraerythrocyte sodium (Na) and potassium (K) levels, as well as transmembrane fluxes of sodium (Na‐influx and Na‐efflux rate constant). Intraerythrocyte Na and K concentrations were determined by flame photometry. The Na‐influx and Na‐efflux rate constant were calculated from uptake values for22Nain vitro. In NMH the Na‐influx and Na‐efflux rate constant were significantly higher while intraerythrocyte Na and K levels did not differ from the controls. Patients with MH tended to have an elevated intraerythrocyte Na concentration, but an unchanged Na‐influx and Na‐efflux rate constant relative to controls. The increased rate of erythrocyte membrane transport of Na in treated NMH could be due to a stimulatory effect of antihypertensive treatment on cellular Na transport. Patients with treated MH do not show this effect and, in addition, tend to have an elevated intraerythrocyte Na concentration, which is compatible with the existence of a more pronounced abnormality of cellular

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00206.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY