ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1983.tb08592.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACT.Three consecutive head nurses developed liver injury after years of handling cytostatic drugs. They had neurological symptoms associated with elevated serum alanine amino‐transferase (ALAT) and alkaline phosphatase (ALP) levels. Liver histology showed portal hepatitis with piecemeal necrosis in one of them, the others had hepatic fibrosis and fat accumulation. The subjects' livers were metabolically active as reflected by adaptive and toxic changes in cellular ultrastructure. After withdrawal of the drugs, serum ALAT and ALP values fluctuated between normal and 2–3 times elevated. Follow‐up biopsies demonstrated an increase in collagen fibres and a decrease in microsomal enzyme activity, as reflected by arylhydrocarbon hydroxylase activity in vitro. The findings suggest that handling of cytostatic drugs may insidiously damage the liver, which, with time, seems to lead to irreversible fib

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1983.tb08593.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACT.Two patients with severe hemophilia B complicated with antibodies against factor IX have been treated 13 and 10 times, respectively, with high doses of factor IX concentrate in combination with cyclophosphamide over a period of 10 years. During this treatment a lowering of the anamnestic response was observed over the years. Both patients have now been treated with factor IX and hydrocortisone but no cyclophosphamide in order to find out if real tolerance was induced. One patient received such treatment three times and the other once. Their inhibitor titer following these treatment episodes never ecxeeded 0.3 U/ml (˜0.9 BU/ml) and 0.9 U/ml (˜2.7 BU/ml) which is of the same order of magnitude as following the combined treatment (factor IX, hydrocortisone and cyclophosphamide). It is therefore suggested that these patients have been converted from high responders (10–100‐fold increase in the inhibitor titer on the original treatment with factor IX and hydrocortisone) into low repsonders showing a very reasonable inhibitor increase after treatment with factor IX and hydrocortisone but no cyclophosph

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1983.tb08594.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACT.One hundred and eighteen patients with hemophilia A or B died in Sweden between 1957 and 1980. The causes and circumstances of death have been the subject of a retrospective study. The most striking feature was the increase in age at death. In severe hemophilia cases the age increased from 19 in the first half of the period to 50 in the second. In moderate and mild hemophilia cases the increases were similar, although less pronounced. The main cause of death was intracranial hemorrhage, which accounted for one‐third of all deaths. In the last 12‐year period, however, no patient below the age of 45 had succumbed to this. Age‐related causes of death, such as malignancy and ischemic heart disease, had increased, as was to be expected from the increase in the mean and median ages of living hemophiliacs. The proportion of deaths unrelated to hemophilia was 36%. Antibodies were found in 5 (16.7%) of the patients with severe hemophi

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1983.tb08595.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACT.A total of 77 sudden coronary deaths (SCD) in men and seven in women occurred during a 6‐year follow‐up in a population comprising 6510 men and 5800 women aged 30–59 years in four areas of Finland. About 60% of all coronary deaths in men aged 40 and over were SCDs. The most common place of death was home; only six cases reached hospital. The most common time for SCD was at 7 a.m. ‐3 p.m. and the most common day was Friday. Deaths were evenly distributed over the year. At the time of the baseline study—3 1/2 years before death on an average—male SCD victims showed more symptoms and signs suggestive of coronary disease than those who suffered a non‐sudden coronary death or a non‐fatal myocardial infarction. More than half of the SCD victims had probable coronary disease at the time of the baseline study. Heart disease was a more common cause of death among the mothers of male SCD victims than among the adult Finnish female population as a whole. This study indicates that the majority of candidates for later SCD can be detected early enough for secondary prevention

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1983.tb08596.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACT.Three patients were treated after ingestion of an overdose of dapsone (1–10 g). A considerable acute cyanosis due to methaemoglobinaemia was followed by a late haemolysis within 1–2 weeks. Activated charcoal given orally in multiple doses (20 g × 4/day) shortened the half‐life of dapsone to 12.7+0.7 hours, i.e. to about 1/3‐1/6 of the preceding control value. The half‐life of dapsone was about 10 hours during each of the three 5‐hour haemodialysis treatments given to one patient. However, owing to the rebound phenomenon between haemodialyses, the half‐life of dapsone from the start of the first to the end of the third haemodialysis was 26 hours. The efficacy of orally administered activated charcoal is fully comparable to that of haemodialysis in increasing the rate of elimination of dapsone and its metabolite monoacetyldapsone. Activated charcoal is cheap, it can be administered anywhere and its administration rarely involves

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1983.tb08597.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACT.Eleven patients with a serum phosphate concentration below 0.3 mmol/1 were detected in a prospective study of severe hypophosphatemia carried out over 7 weeks on 13579 adult inpatients. For only one of these patients had a serum phosphate determination been requested by the ward, whereas the remaining cases of severe hypophosphatemia were detected as a result of the study. The most common cause of unexpected severe hypophosphatemia was chronic alcoholism.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1983.tb08598.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACT.Three women with insulin‐dependent diabetes mellitus (IDDM) from childhood and early development of diabetic retiaopathy are described. Insulin requirement was reduced to 5–12 IU daily in all three after relatively uncomplicated births and all had very brittle diabetes on this dosage. At re‐examination 16–22 years after these births and after 34–42 years of IDDM, regression of retinopathy was observed in two patients, while the third had a light retinopathy at the same level as initially. Other diabetic complications were few and none of the patients had nephropathy. Pituitary examination revealed incomplete hypopituitarism in all cases, human growth hormone (HGH) being the sole common factor lacking. These findings and a review of four similar cases reported previously lend some support to the hypothesis of HGH as a possible pathogenetic co‐determinant in the development of diabetic

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1983.tb08599.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACT.The aims of the present study were to compare various methods for assessment of residual insulin production and to evaluate its role in the metabolic regulation in insulin‐dependent, type I diabetes mellitus. Glycosylated hemoglobin (HbA1) was used as a measure of the long‐term glycemic control. Twenty‐eight patients with type I diabetes mellitus with onset before the age of 30 and with a duration of less than 6 years were studied. C‐peptide in plasma in the fasting state, after glucagon stimulation, and the 24‐hour urinary excretion were measured. Fasting plasma C‐peptide was detected in 61%, and 39% showed a significant rise after glucagon stimulation. The increment correlated negatively with HbA1(rs=‐0.57,p<0.001), as did the 24‐hour urinary excretion (rs=‐0.61,p<0.001). The 16 patients with urinary C‐peptide values of at least 1 nmol had a mean HbAaof 8.9+0.3 %, as opposed to 11.6+0.5% for those excreting less (p<0.001). Measurement of the 24‐hour urinary excretion of C‐peptide provides a reliable method for evaluating res

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1983.tb08600.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACT.Blood and urine glucose values and the prevalence of diabetes mellitus were determined in the course of a health survey covering inhabitants of Tampere, Finland, aged 85 or over. Out of the total cohort, 561 (83%) subjects, of whom 82% were women, were examined. A high blood glucose level (≥7.0 mmol/l) was recorded in 10% of the males and 7% of the females. The prevalence of diabetes mellitus in the series was 17%. Five per cent of the total series were on drug treatment for their diabetes; 5 % of the diabetics were on insulin therapy and 25% took oral antidiabetic drugs, while 70% were either on diet or had no treatment. Diabetes seems to be common among the very aged, but it is generally mild and easy to trea

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1983.tb08601.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY