ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00256.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.tb00257.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Serum lipoproteins and apolipoproteins were studied in 14 hypertriglyceridaemic (HTG) patients during a 24‐week period of treatment with gemfibrozil, and after a 6‐week washout period. A marked decrease in very low density lipoprotein (VLDL) cholesterol and triglyceride was observed. There was an increase in high density lipoprotein (HDL) cholesterol, particularly the HDL3component. A slight increase in low density lipoprotein (LDL) cholesterol was observed after 12 weeks, but this had almost disappeared after 24 weeks. The treatment resulted in an increase in serum apolipoprotein A‐II levels and a reduction in serum apo C‐III and apo E. VLDL subfractionation by density gradient centrifugation in four subfractions of decreasing size (A, B, C and D) showed a predominant reduction of the large subfractions A, B and C, while the decrease in VLDL‐D was less marked. Percentage changes from the baseline level of VLDL‐A and VLDL‐D cholesterol were found to be inversely correlated with percentage changes in HDL and LDL cholesterol, respectively. This might reflect a transfer of cholesterol from VLDL‐A to HDL, and from VLDL‐D to LDL. The above data suggest fibrate‐induced stimulation of lipoprotein lipase, and indicate that the enhanced transfer of cholesterol from VLDL to LDL, induced by fibrates in HTG patients, is less pronounced after a prolonged

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00258.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Little is known about the relationship between hypothyroidism and the parasympathetic nervous system. R‐R interval variations revealed by electrocardiogram (ECG) are known to be a useful clinical indicator of abnormalities of parasympathetic nervous system activity. Studies were conducted in hypothyroid patients, and significant reductions in R‐R interval variations were observed in patients with primary severe hypothyroidism due to Hashimoto's thyroiditis, and in patients with Graves'disease who became severely hypothyroid during antithyroid drug therapy. R‐R interval variations were restored to normal levels in both groups of patients after treatment. The present investigation suggests that in marked hypothyroidism there are hypofunctional abnormalities in the parasympathetic nervous system in association with a reduction in the levels of serum T4a

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00259.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Forty‐one patients with hyperprolactinaemia and suspected prolactinomas were studied. Growth hormone (GH) and thyrotropin (TSH) secretory patterns after thyrotropin releasing hormone (TRH) were affected in the majority of patients. The disturbances were observed regardless of tumour size as indicated by the radiological sella size. In patients with hyperprolactinaemia and normal‐sized sella turcica, an abnormal GH and TSH response to TRH can be helpful in the diagnosis of a microadenoma. The hyperprolactinaemia per se and its effect on dopaminergic hypothalamic neurones may be the cause of the GH and TSH response. By contrast, many patients with macroprolactinomas showed insufficient GH secretory capac

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00260.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.The Copenhagen City Heart Study is a prospective cardiovascular population study designed to evaluate the incidence of and risk factors for cardiovascular disease. A random population sample comprising approximately 20000 individuals was invited to participate. Blood pressure was measured, and information regarding the use of antihypertensive medication was collected in an initial survey during the period 1976‐1978 (attendance rate 74%) and from a second survey during the period 1981‐1983 (attendance rate 70%). A significant increase in systolic and diastolic blood pressure between survey 1 and survey 2 was found among both men and women ≥ 40 years of age and not using antihypertensive medication. The increase in blood pressure in the follow‐up survey could not be explained by changes in methods, changes in the prescription of antihypertensive medication, or selection bias. Factors associated with changes in systolic and diastolic blood pressure were examined by multiple linear regression analysis. Both increase in body mass index and increase in alcohol consumption were positively correlated with changes in systolic and diastolic blood pressure, while use of antihypertensive medication, a high value of body mass index at survey 1 and a high level of education were negatively correlated with changes in systolic and diastolic blood pressure. Female sex and advanced age were also negatively correlated with changes in diastolic blood pressure. Consumption of tobacco and alcohol, income and changes in consumption of tobacco were not significantly correlated with changes in systolic and diastolic blood p

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00261.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Paraneoplastic fever is well known, and is not an uncommon problem in daily practice. In an effort to ameliorate tumour‐induced fever we randomized 48 patients to receive three different non‐steroid anti‐inflammatory drugs: Naproxen (500 mg d−1), Indomethacin (75 mg d−1) or Diclophenac sodium (75 mg d−1). All patients had solid tumours, and microbial infection had been excluded. All three drugs were equally effective in bringing the temperature down to normal for a period of 30‐33 d. Naproxen had the most rapid effect. In cases of fever relapse with the first drug, when the other two drugs were given instead, both proved equally effective. No side‐effects were observed. We conclude that Naproxen, Indomethacin and Diclophenac sodium are equally effective in ameliorating paraneoplastic fever. In relapse, a second drug given subsequently can be ef

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00262.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Continuous subcutaneous insulin infusion (CSII) and multiple injections (MI) have been shown to have metabolic advantages in highly‐selected insulin‐dependent diabetics (IDDs), but there have been few comparative studies in self‐selected IDDs. With MI, the optimal insulin preparation for overnight insulin delivery has not been defined. We compared conventional 2‐3 injection therapy (CT), CSII and MI with human isophane insulin (MI/human isophane) and human ultralente insulin (MI/human ultralente), respectively, at bedtime in self‐selected IDDs. Of 275 IDDs who were invited to participate, 52 individuals (18.9%) entered the study. Most indices of glycaemic control showed better values on CSII and also on MI compared to CT, but the differences were small. Fasting blood glucose was higher on MI/human ultralente than on MI/human isophane. Only one subcutaneous abscess and one case of ketoacidosis requiring hospitalization occurred on CSII. Serious hypoglycaemic episodes were non‐significantly increased on intensified therapy. Most patients clearly preferred intensified insulin therapy; approximately on

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00263.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.We compared measurements of parathyroid hormone (PTH) using two assays, in order to detect intact PTH and midregion/C‐terminal PTH (M/C‐PTH) in a variety of calcium metabolic disorders. The series consisted of a total of 101 patients, including subjects with primary hyperparathyroidism (n=24), hypoparathyroidism (n=18), hypercalcaemia of malignancy (n=10), moderate chronic renal failure (n=14), chronic renal failure undergoing haemodialysis (n=19), and small bowel disorders (n=16). The intact PTH assay was superior to the M/C‐PTH assay in reflecting parathyroid function in primary hyperparathyroidism, hypoparathyroidism and hypercalcaemia of malignancy. In patients with chronic renal failure, both assays were indicators of a comparable number of patients with elevated PTH levels. Intact PTH proved most reliable in detecting changes in parathyroid hormone secretion in response to variations in ionized calcium induced by haemodialysis. In patients with extensive intestinal resection, both assays showed increased levels of PTH. It is concluded that measurement of intact PTH is a more reliable index of parathyroid function than measurement of midregion/C‐terminal PTH. Thus such an approach should be the one of choice for clinical evaluation of calcium home

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00264.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.The aim of this study was to determine the frequency of various metabolic risk factors for coronary artery disease (CAD) in 246 male patients studied over a 2‐year period. CAD was diagnosed on the basis of a history indicative of angina pectoris, an electrocardiogram diagnostic of myocardial ischaemia, and a positive coronary angiogram. Thirty‐eight per cent of this population had diabetes, hypertension or both. Of the remaining individuals, 39% had a plasma cholesterol concentration ≥ 5.2 mmol l−1, whereas 23% had a cholesterol concentration<5.2 mmol l−1. Plasma lipid and lipoprotein levels of a nonsmoking subset of those subjects with a total cholesterol concentration<5.2 mmol l−1were compared with values of a matched group of individuals who did not have significant vessel disease as revealed by angiography. The results of these investigations indicated that patients with CAD and a plasma cholesterol concentration<5.2 mmol l−1exhibited an increase in plasma triglyceride concentration and a decrease in plasma HDL‐cholesterol concentration. Since these subjects were not diabetic, hypertensive or hypercholesterolaemic, it is suggested that the observed changes in triglyceride and HDL metabolism made a major contribution to the CAD in th

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1990.tb00265.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY