ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb03351.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

“The sceptics in medicine have a hard time of it. It is much more difficult to be convincing about ignorance concerning disease mechanisms than it is to make claims for full comprehension, especially when the comprehension leads, logically or not, to some sort of action. When it comes to serious illness, the public tends, understandably, to be more sceptical about the sceptics, more willing to believe the true believers.”(Lewis Tho

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb03352.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACT.Suhonen O, Aromaa A, Reunanen A, Knekt P (Research Institute for Social Security, the Social Insurance Institution, Helsinki, Finland). Alcohol consumption and sudden coronary death in middle‐aged Finnish men.The association between consumption of alcoholic beverages (spirits, beer and wine) and coronary heart disease (CHD) mortality, especially the incidence of sudden coronary death (SCD), was investigated in a 5‐year prospective population study comprising 4532 men aged 40–64 years. The amount of alcohol used was estimated on the basis of answers to a self‐filled structured questionnaire. The incidence of SCD was statistically significantly lower among abstainers than among alcohol consumers. The relative risk of SCD of alcohol consumers in comparison with abstainers was largest in the oldest age group and it became more apparent after a follow‐up of a couple of years. Only the consumption of spirits was positively associated with the incidence of SCD. Among non‐smokers the incidence of SCD was statistically significantly higher in consumers than in abstainers, a similar but not significant trend was observed among current smokers. The positive association between alcohol consumption and incidence of SCD was detected both in CHD‐free men and in men with prior CHD. Consumption of alcoholic beverages, and in particular of spirits, is associated with an increased risk of SCD i

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb03353.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACT.Hangaard J, Rasmussen O, Nørregaard‐Hansen K, Jørgensen N, Simonsen EE, Nørgaard‐Pedersen B (Department of Internal Medicine, Haderslev Hospital, Haderslev, and Department of Clinical Chemistry, Sønderborg Hospital, Sønderborg, Denmark). Early diagnosis of acute myocardial infarction with a rapid latex agglutination test for semi‐quantitative estimation of serum myoglobin.A rapid latex agglutination test for the detection of elevated levels of myoglobin in serum was evaluated in a prospective study of 236 patients consecutively admitted to a Coronary Care Unit on suspicion of acute myocardial infarction (AMI). The final diagnosis was made according to the WHO criteria. The prevalence of AMI was 0.45 with a male to female ratio of 2:1. In all patients at least two blood samples were collected with 4 hours interval 4–12 hours after the onset of symptoms. All sera were analysed for myoglobin by a latex agglutination test and by a radioimmunoassay (RIA). The latex test was performed twice, first as an emergency test by the technical assistant on duty and later by another well‐trained technical assistant as her daily routine work. If the latex test was carried out each day by the same well‐trained technical assistant, the test results agreed well with the RIA test results, and the false‐negative fraction for patients with AMI constituted 0.06 and the false‐positive fraction for patients without AMI 0.46. However, when the latex test was performed by the occasional technical assistant on duty, a relatively high degree of discrepancy was observed between the latex test results and the RIA test results, thus giving a false‐negative fraction of 0.11 and a false‐positive one of 0.36. In conclusion, performed under optimal laboratory conditions, the latex test can be used as a reliable method to estimate elevated levels of serum myoglobin. However, used as a bedside emergency examination, the test results correlated rather poorly to the RIA test results, and consequently the latex myoglobin test seems to be of minor clinical importance in the early evaluation of pat

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb03354.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACT.Viitanen M, Eriksson S, Asplund K, Wester PO, Winblad B (Departments of Internal Medicine and Geriatric Medicine, University of Umeå, Umeå, Sweden). Determinants of long‐term mortality after stroke.Risk factors of death for a population of 409 patients with well‐defined cerebrovascular disease (patients with subarachnoidal hemorrhage excluded) admitted to the Stroke Unit were studied with the aid of the life table technique, log rank test, and multivariate analysis with BMDP's program for regression on the survival curves with Cox's proportional hazard model. The estimated proportion of survivors was 77% after three months, 69% after one year, and 32% after five years. Patients with intracerebral hemorrhage and embolic cerebral infarction had the worst outcome. Impaired consciousness on admission was the most important risk factor of death followed by high age, previous cardiac failure, diabetes mellitus and mal

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb03355.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACT.FranzÉn J, Johansson BW, Gustafson A (Department of Internal Medicine, University Hospital, Lund and Section of Cardiology, Department of Internal Medicine, MalmÖ General Hospital, MalmÖ, Sweden). Reduced high density lipoproteins as a risk factor after acute myocardial infarction.In a group of normocholesterolemic, non‐diabetic middle‐aged males surviving an acute myocardial infarction for 4±2 years (mean ± SD), we have previously described a low apolipoprotein A‐1 and a deficient fibrinolytic activity as two major characteristics. In the present study we have followed morbidity and mortality risk factors for five years in these males. Mortality was 40% in a hypertensive group and 16% in a normotensive group. In the normotensive group mortality was related to reinfarction. Furthermore, patients with a poor prognosis in the normotensive group had lower high density lipoprotein (HDL) cholesterol and lower apolipoprotein A‐I concentration in plasma than patients with a good prognosis. Unexpectedly, in the hypertensive group death was related to a low (p<0.05) cortisol concentration in urine. It is concluded that a low HDL level may be a bad prognostic sign in males who have sustained an acute myocardial infarction and show no evidence of other risk factors, such as diabetes, hypercholesterolemia or

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb03356.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACT.Valdemarsson S, Hedner P, Nilsson‐Ehle P (Departments of Internal Medicine and Clinical Chemistry, University Hospital, Lund, Sweden). Increase in hepatic lipase activity after testosterone substitution in men with hypogonadism of pituitary origin.Ten men with hypogonadism of pituitary origin were studied before and during testosterone substitution therapy with regard to effects on the activities of hepatic lipase (HL) and lipoprotein lipase (LPL) in postheparin plasma, and on plasma lipoprotein concentrations. The mean (±SEM) testosterone level increased from 1.8±0.5 to 16.3±2.4 nmol/l). The mean activity of HL rose from 327.1 ±35.2 to 432.8±57.2 mU/ml (p<0.02), while the activity of LPL did not change significantly, 71.0+9.1 mU/ml before and 62.2±3.8 mU/ml after treatment. No significant alterations in lipoprotein concentrations were recorded. These results indicate that a normal testosterone level is of importance for maintaining the activity of HL in men, thereby contributing to the sex difference previously recorded for HL a

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb03357.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACT.Laatikainen L, Teramo K, Hieta‐Heikurainen H, Koivisto V, Pelkonen R (Department of Ophthalmology, I and II Departments of Obstetrics and Gynaecology, III Department of Medicine, Helsinki University Hospital, Helsinki, Finland). A controlled study of the influence of continuous subcutaneous insulin infusion treatment on diabetic retinopathy during pregnancy.Forty consecutive pregnant patients with insulin‐dependent (Type I) diabetes mellitus were randomized at the end of the first trimester for treatment with conventional insulin therapy (CIT) or continuous subcutaneous insulin infusion therapy (CSII). Nine patients randomized into the CSII group declined the pump treatment. The mean glycosylated haemoglobin (Hb A1c) decreased (p<0.001) both in the CIT and the CSII groups with no difference between the groups. Some deterioration in retinopathy was found in 2/18 patients in the CIT group, in 5/13 in the CSII group, and in 3/9 of those who declined the pump treatment. The proportion of patients whose retinopathy progressed did not differ significantly between the groups, and in the majority the deterioration was mild. However, two patients in the CSII group developed acute ischaemic retinopathy, which progressed to proliferative stage in spite of laser treatment. In these two cases the decrease in the Hb Alclevel was among the greatest and fastest in the study. These data suggest that a rapid near normalization of glycaemic control by CSII during pregnancy can accelerate the progress of retinopathy in poorly controlled diabetic patie

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb03358.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACT.Sarlund H, Laakso M, PyÖrÄlÄ K, PenttilÄ I (Departments of Internal Medicine and Clinical Chemistry, Kuopio University Central Hospital, Kuopio, Finland). Fasting, postprandial and postprandial plus glucagon‐stimulated plasma C‐peptide levels in non‐insulin‐dependent diabetics and in control subjects.We have studied fasting, postprandial and postprandial plus glucagon‐stimulated plasma C‐peptide levels in 149 non‐insulin‐dependent diabetics treated either with diet or oral drugs and in 101 non‐diabetic control subjects. Diet‐treated diabetics showed the highest fasting, postprandial and post‐glucagon C‐peptide levels in both sexes. In men, diabetics treated with oral drugs showed lower postprandial and glucagon‐stimulated C‐peptide levels than control subjects, while in women C‐peptide levels in this group of diabetics were similar to those in control subjects. The distribution of individual plasma C‐peptide levels was wide in non‐insulin‐dependent diabetics and control subjects and there was considerable overlapping in plasma C‐peptide distribution for diabetics and control subjects. Fasting and post‐glucagon plasma C‐peptide levels in diabetics showed an inverse association to plasma glucose levels and a positive association to degree of obesity, but no as

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb03359.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACT.Helve E, Koivisto VA, Lehtonen A, Pelkonen R, Huttunen JK, NikkilÄ EA (Third Department of Medicine, University of Helsinki, and National Public Health Institute, Helsinki, Finland). A crossover comparison of continuous insulin infusion and conventional injection treatment of type I diabetes.We evaluated the feasibility and effectiveness of continuous subcutaneous insulin infusion therapy (CSII) as compared to conventional injection treatment (CIT) in an ordinary diabetic clinic in a one‐year randomized crossover study of 65 type I diabetic patients. Home blood glucose levels were lower during CSII (8.6±0.2 mmol/1, mean ± SEM) than during CIT (9.1±0.3 mmol/1,p<0.05). During the first six months, HbA1fell on CSII therapy (from 10.6±0.4 to 9.7±0.3%,p<0.001), whereas no change occurred during CIT. After the crossover, HbA1decreased again on CSII (p<0.05), but rose in patients shifted from CSII to CIT (p<0.05). The fall in glycosylated haemoglobin during CSII correlated with the initial HbA1level (r=0.54,p<0.001). Ketoacidosis was more common during CSII (16 vs. 2 verified episodes). Hypoglycaemia occurred infrequently, without difference between CSII and CIT. Fifty‐six per cent of the patients preferred CSII after the study. In conclusion, while CSII slightly improves the metabolic control, the improvement in the unselected study population is less than previously reported among highly selected

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb03360.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY