ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02723.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02724.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTEmergency treatment of acute, severe hypertension defined as diastolic blood pressure (DBP) ≥ 135 mmHg combined with cerebral symptoms was prospectively monitored in a randomized multicenter study including 64 patients. Treatment was divided into two periods. In the first hour the patients were observed in the supine position after being given 40 mg furosemide intravenously. If DBP remained>125 mmHg (n=52), the patients were put on fractionated diazoxide administered intravenously (n=28) or dihydralazine administered intramuscularly (n=24). Blood pressure (BP) decreased with diazoxide from an average of 241/149 mmHg to 180/111 mmHg after 5 hours and with dihydralazine from 237/149 to 161/101 mmHg. The inter‐individual BP response varied considerably. A clear and identical regression in neurological symptoms was observed on both drug regimens. No new neurological symptoms were seen to develop. It is concluded that a gradual fall in BP can be obtained after fractionated dosage of diazoxide (i.v.) as well as after dihydralazine (i.m.). The indication of acute parenteral therapy compared to less aggressive oral treatment is discus

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02725.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTCerebral symptoms were registered in a multicenter study including 64 patients with severe hypertension, diastolic blood pressure (DBP) ≥135 mmHg, and more or less pronounced hypertensive encephalopathy. The symptoms were: headache (70%), dizziness (35%), consciousness disturbances (28%), nausea (27%), paresis (23%), blurred vision (22%), para‐esthesia (21%) and vomiting (14%). None had convulsions or coma. Initial treatment was furosemide i.v., and if DBP was ≥125 mmHg after one hour, patients were randomized to treatment with either i.v. diazoxide (bolus injections of 75‐150 mg) or i.m. dihydralazine (bolus injections of 6‐12.5 mg). A gradual fall in blood pressure (BP) was obtained in all three groups. Along with BP reduction a substantial regression of neurological symptoms was registered. After 5 hours only minor cerebral symptoms were present without significant difference between diazoxide and dihydralazine. None developed cerebral complications. The study failed to show a significant correlation between BP reduction and regression of neurological symptoms graded semiquantitatively. Reduction of BP by titration using small repeated bolus injections is recommended, but oral treatment should be considered in the patients who are able to ingest peroral medication in spite of neurologica

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02726.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTThe Stockholm Metoprolol Trial is a prospective double‐blind placebo‐controlled postmyocardial infarction study of 301 patients treated with metoprolol, 100 mg b.i.d., or matching placebo for three years. From this study we have retrospectively evaluated the outcome in patients with a history of treatment for hypertension prior to the index infarction. There were 41 such patients in the placebo group and 35 in the metoprolol group. Blood pressures during follow‐up were nearly identical in the two groups. During the three years 11 patients died in the placebo group and 7 in the metoprolol group. Corresponding figures for nonfatal events such as reinfarction, coronary artery bypass surgery, cerebrovascular events and lower limb amputation were 12 vs. 1 (p<0.005), 3 vs. 0, 4 vs. 0 and 1 vs. 0, respectively. The numbers of patients with fatal and nonfatal events were 24 vs. 8 (p<0.01). In a retrospective subgroup analysis the results must always be interpreted with caution. The present results may, however, imply that postinfarction treatment with metoprolol reduces nonfatal atherosclerotic complications, especially nonfatal reinfarctions, in patients with a history of hyperte

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02727.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTTo study the response of glucose counterregulation to insulin‐induced hypoglycemia, six normals were given a 4‐hour infusion of insulin (2.4 U/h) ± somatostatin (50 μg/h). Supplementary glucagon (1.5 or 3.0 ng/kg/min) was given in additional experiments. In a separate study, glucagon was supplemented for 4 hours as a constant rate infusion (3.25 ng/kg/min) or at rates stepwise increasing from 1.5 to 5.0 ng/kg/min. Insulin decreased blood glucose by 1.5 mmol/1 and simultaneous suppression of glucagon resulted in a more pronounced hypoglycemia enhancing the adrenaline and Cortisol responses. The hyperglycemic effect of glucagon substitution (3 ng/kg/min) faded out after about 2 hours, whereafter exaggerated adrenaline and Cortisol responses to hypoglycemia were seen. A comparison between the effects of steady state hyperglucagonemia and gradually appearing hyperglucagonemia on the counterregulation of hypoglycemia revealed no significant differencies in glucose, adrenaline and Cortisol responses to insulin. It is concluded that the glycemic effect of glucagon is transient in the hypoglycemic state. When the hepatic responsiveness to this hormone is decreased during hypoglycemia, adrenaline becomes the essential protective f

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02728.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTA number of 2 325 serum samples from a population of in‐ and outpatients were collected during a six‐month period in order to evaluate the usefulness of various thyroid function tests in the clinical laboratory routine. The samples were analysed with the following thyroid function tests: total triiodothyronine (T3) (TT3), total thyroxine (T4) (TT4), free T3index (FT3I), free T4index (FT4I) and thyrotropin (TSH). One to two years after the primary evaluation, a follow‐up was performed and the final diagnoses were checked in the patients' records. The values of these parameters in the diagnosis of hyperthyroidism were: FT3I>FT4I>TT3>TT4. The corresponding results in the diagnosis of hypothyroidism were: TSH>FT4I>FT3I=TT3. No single test could detect both hyper‐ and hypothyroidism effectively. The only one‐step strategy for thyroid evaluation in patients without apparent clinical signs of hyper‐ or hypothyroidism would therefore be the combined determination of T3and TSH. The study also showed distinct differences between the reference values of the healthy population and patients without thyroi

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02729.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTBasal plasma concentrations of thyroxine (T4), 3,3′,5‐triiodothyronine (T3), free T4index (TF4I), free T3index (FT3I) reverse T3, 3,3′,5‐triiodothyronine (rT3), resin T3uptake (TR3U), thyroxine‐binding globulin (TBG), thyrotropin (TSH), prolactin (PRL) and growth hormone (GH) as well as thyrotropin releasing hormone (TRH) stimulated TSH, PRL and GH were investigated in 31 consecutive male patients (mean age 41 years) with chronic alcoholism. According to the histology of their liver biopsies the patients were divided into three groups: patients with normal livers, steatosis and cirrhosis. The control group consisted of 30 healthy males. The patients had abstained from alcohol for at least one week when studied, and they were on a nutritionally adequate diet. All had consumed a daily minimum of 52 g ethanol for at least 5 years. None of the patients had severe or decompensated liver disease. The patients had significantly reduced T3and rT3plasma levels compared to normals. Patients with cirrhosis of the liver had increased TBG and normal RT3U levels, while those without cirrhosis had increased RT3U and normal TBG levels. Plasma concentrations of basal as well as TRH‐stimulated TSH and PRL were unchanged in alcoholic patients, whereas basal as well as stimulated GH levels were increased in cirrhotic alcoholics. It is concluded that alcohol per se influences T3levels, but not the part of the hypothalamic‐pituitary axis studied, and that the binding proteins are mostly determined by the degree of

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02730.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTSerum total thyroxine (T4), triiodothyronine (T3) and thyrotrophin (TSH) levels were determined among 65‐84‐year‐old Finnish men living either in eastern Finland (n=309) or in southwestern Finland (n=389). The mean value for serum total T4was 112.2±23.0 nmol/1 in eastern Finland and 111.3±21.9 nmol/l in southwestern Finland. The mean value for serum T3was 1.76±0.30 nmol/1 in eastern Finland and 1.75±0.46 nmol/1 in southwestern Finland. Serum TSH values showed the mean for men from eastern Finland to be 3.25±2.29 mU/1 and the mean for men from southwestern Finland to be 3.11±1.83 mU/1. No differences were found in the means of the thyroid function tests between the two areas. Serum T4levels were not related to age. Serum T3values fell with age. In both areas, serum TSH levels were highest among men 70‐74

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02731.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTRhythm characteristics in the about‐daily (circadian) and about‐yearly (circannual) frequency ranges were assessed for urinary melatonin. Clinically healthy women in Minnesota, USA, and Kyushu, Japan, were sampled around the clock once in 1‐4 seasons. Possible differences that could reflect the large difference in breast cancer incidence in these two geographic locations were investigated. Each subject's risk of developing breast cancer, cardiovascular diseases resulting from an elevated blood pressure, and emotional conditions was numerically evaluated according to epidemiologic questionnaires. A prominent circadian rhythm characterizes urinary melatonin in both populations, peaking in the middle of the night. The American women exhibit a larger circadian rhythm‐adjusted mean (mesor) than do the Japanese women. A circannual rhythm is also apparent in the North American women, but not in the Japanese women. The circadian mesor of urinary melatonin correlates negatively with the risk score of emotional depression and positively with that of developing cardiovascular d

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02732.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY