ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1984.tb04977.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

ABSTRACTOne hundred and fourteen in‐ and out‐patients from a department of internal medicine were interviewed, on the basis of a questionnaire with the following key questions: 1) Their attitudes to medical trials with man as the subject. 2) Their emphasis on informed consent. 3) Their attitudes to inclusion of patients not being able to give informed consent. 4) Their attitudes to tentative participation in 4 concrete projects. In all, 98% considered doctors' and patients' collaboration on new therapeutical methods both necessary and desirable. Eighty‐eight per cent considered information of patients participating in trials a prerequisite. Eighty‐six per cent accepted participation in scientific trials based on the guarantee of the doctors responsible. Of these 86%, 58% felt that a scientific‐ethical committee's accept of the project implied an extra element of security. Seventy‐five per cent replied that patients not being able to give informed consent themselves could be included in scientific trials. The majority, 77%, added that patients' relatives would then have to accept, 20% that such trials could be based on the participating doctors' responsibility, and only 2% that such a responsibility was to place on scientific‐ethical committees. In the 4 concrete projects, answers followed a uniform trend: full information of patients was demanded by approximately 80%, and acceptance of participation resting with responsible doctors in more than 80%. Less than half of these 80% felt that evaluation by a scientific‐ethical committee would add to pat

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1984.tb04978.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

ABSTRACTPeople with parenchymal iron overload exhibit an elevated serum iron concentration and a raised transferrin (TIBC) saturation early in the course of the disease. They can therefore be detected by simple laboratory tests before organ damage has occurred. In this study running for 2 months, 10512 samples from approximately 8750 patients and blood donors were examined in a county hospital in Central Sweden. Abnormal TIBC saturation (>70%) was found in 1.7% of the samples. This abnormality was caused by physiological fluctuations in serum iron in 44%, liver disease in 22%, blood disorder in 10%, iron therapy in 10.5% and parenchymal iron overload in 11.5%. The diagnosis of iron overload was confirmed by measuring the serum ferritin concentration and by performing the desferrioxamine test, liver biopsy, quantitative phlebotomy and family studies including HLA typing. We found a prevalence of iron overload of 0.24%. This figure is almost certainly too low because some affected patients were probably lost because of TIBC desaturation induced by inflammatory conditions.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1984.tb04979.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

ABSTRACTSerum very low (VLDL) and high density lipoproteins (HDL) from 17 hyperlipidemic patients and 10 normal subjects have been isolated by preparative ultracentrifugation, and the electrophoretic patterns of apolipoprotein E (apo E) isoforms in the lipoproteins have been examined by isoelectric focusing. Type III hyperlipidemia (dyslipoproteinemia) has been suggested to be a disease caused by an abnormal mutant of the apo E‐3 isoform. In accordance with this, all patients with type III hyperlipidemia in the present study showed lack of apo E‐3 in VLDL. However, all these patients demonstrated a protein zone corresponding to apo E‐3 in their HDL fraction. Patients with other types of hyperlipidemia or normal subjects who showed an apo E‐4 variant in VLDL had an HDL that lacked apo E‐4. The results support the hypothesis that type III hyperlipidemia is due to an abnormal composition of the VLDL particles rather than a result of an abnormal mutant o

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1984.tb04980.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

ABSTRACTSixty‐four patients with clinically, radiologically and histopathologically established sarcoidosis were studied by bronchoscopy and static and dynamic spirometry. Sarcoid bronchostenosis was established by bronchoscopy in nine patients. Twenty‐one had bronchial sarcoidosis without stenosis and 34 had no evidence of bronchial sarcoidosis. Patients with sarcoid bronchostenosis showed a marked impairment of lung function, mostly with an obstructive pattern. There was no improvement in lung function after bronchodilatation in these patients. Obstructive spirometry pattern was also found in three patients with bronchial sarcoidosis stage II without stenosis. None of the patients without bronchial sarcoidosis had an obstructive pattern. All six patients with restrictive spirometry pattern in the two groups without bronchostenosis had stage II sarcoidosis. At follow‐up, lung function had improved in five patients, four with sarcoid bronchostenosis and one patient with stage II without bronchial sarcoidosis. Four of these patients were treated with oral corticosteroids. When clinical signs of airway obstruction are present in patients with sarcoidosis, bronchial sarcoidosis with or without bronchostenosis should be suspected. When bronchial sarcoidosis is present, oral corticosteroid treatment should be

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1984.tb04981.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

ABSTRACTThe digital skin microcirculation was studied by vital capillaroscopy in 32 consecutive patients with Raynaud's phenomenon. A detailed classification (stages 0–6) of the capillary abnormalities based upon observations of the capillaries in many different sites of the fingers was used. Associated diseases were searched for by an extensive clinical and immunological investigation. Seventeen (53%) of the patients had distinct structural changes in the capillaries but only 6 of them showed a restricted total digital circulation. Fifteen (88%) of these 17 patients displayed an underlying disease and/or immunological abnormalities. The corresponding figure for patients with mild or no capillary changes was 40% (p<0.01). Thus, the presence of marked (≥stage 3) skin capillary abnormalities seems to be a good indicator of an associated systemic disease. The majority of patients in this category improved their capillary status during successful treatment of the underlying disease. We conclude that the form of capillaroscopy used in this study is a sensitive method for evaluating disturbances of the skin microcirculation in patients with Raynaud's phenomenon. The method may also contribute to the clinical evaluation of patients with this syndrome by identifying those with an underlying systemic dise

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1984.tb04982.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

ABSTRACTEight patients with vasospastic disease of the digital arteries were treated with the calcium‐entry blocker nifedipine (capsules), 10 mg t.i.d. and 20 mg t.i.d. The degree of cold‐induced digital vasospasm after local cooling of the finger to 15 and 10°C, measured by strain‐gauge technique, was significantly decreased by nifedipine. The degree of reduction was dose‐dependent. All patients improved symtomatically. The side‐effects of the drug were minor but became more prominent when the dose was increased. We conclude that nifedipine is a useful agent in the treatment of digital vasospast

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1984.tb04983.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

ABSTRACTOne hundred and sixty patients with onset of non‐ketotic diabetes at the ages of 35–70 were investigated for chlorpropamide‐alcohol flush (CPAF), β‐cell function, insulin sensitivity, human leucocyte antigens (HLA), organ specific antibodies and diabetic complications. A positive flush reaction was defined as an increase in facial skin temperature by at least 1.5°C, which was associated with a visible flush reaction in all patients. In accordance with these cirteria, 38% of the patients were considered CPAF‐positive with a mean rise in facial skin temperature of 2.3±0.1°C compared with 0.6±0.1°C in the CPAF‐negative patients (p<0.001). The CPAF‐positive patients could be distinguished from the CPAF‐negative with respect to: 1) higher frequency of first degree family history of diabetes (p<0.05), 2) lower basal and glucagon‐stimulated C‐peptide concentrations (p<0.02 andp<0.001), 3) increased frequency of HLA‐A2 (p<0.01) and decreased frequency of HLA‐B7 (p<0.01). The findings thus support the genetically determined nature of CPAF. Considering the criteria for maturity onset diabetes in the young, it is unlikely that CPAF acts as a genetic marker for this partic

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1984.tb04984.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

ABSTRACTHeart rate and heart rhythm were studied in 19 hyperthyroid patients before and after antithyroid treatment inducing a euthyroid state. The mean 24‐hour heart rate in patients with sinus rhythm and without drugs influencing heart rate was 100 beats/min before and 80 after antithyroid treatment. The difference was greatest in the sleeping hours. The heart rate, especially in the sleeping hours, correlated significantly with serum triiodothyronine but not with serum thyroxine concentration

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1984.tb04985.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

ABSTRACTAn asymptomatic population of 100 women and 101 men was studied with M‐mode echocardiogram to determine the prevalence of mitral valve prolapse (MVP). One of the two patterns characteristic for MVP was found in 8% of the females and 7% of the males. The diastolic mitral valve excursion was significantly higher in the MVP group (p≤0.001). A typical M‐mode pattern in combination with a high mitral valve excursion probably enhances the diagnostic specif

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1984.tb04986.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY