ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02766.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.tb02767.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTThree hundred and twelve patients with peripheral arterial disease were followed up for 8 3/4 years or more (maximum 11 3/4 years) to assess the natural history of the disease and factors determining its outcome. Of the 312 patients, 188 (69%) died during the follow‐up, 68% of the deaths having cardiovascular causes. The 10‐year relative cumulative survival rate was 0.61 for males and 0.48 for females. The role of smoking as a risk factor could not be analysed without bias. In addition to known risk factors diabetes mellitus, cerebrovascular disease and coronary heart disease, the degree of peripheral arterial disease itself also proved to be a risk factor among men. The expected life lost for men with intermittent claudication was 20%, but 44.3% for men with advanced lower limb ischaemia (p<0.01). This difference could not be explained by the well‐known association of advanced ischaemia and diabetes mellitus. The present results therefore suggest that the state of advanced ischaemia indicates larger involvement of the whole of the arterial tree and predicts fatal cardiovascular events among these pat

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02768.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTTissue injury including myocardial infarction leads to a variety of changes in plasma proteins commonly referred to as “the acute phase response”. In this report the concentrations of serum amyloid A protein (SAA) were measured serially in 6 patients with myocardial infarction and 4 with angina. SAA was found to be increased in all patients with infarction, but in no patients with angina. Significantly increased SAA levels were detected 12 hours after the peak level of creatine kinase, and the concentrations of SAA seemed to correlate to the amount of damaged tissue. The SAA‐response was both faster and more extensive than the response of C‐reactive protein (CRP), but the correlation between SAA and CRP was ve

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02769.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTTwenty‐six patients with stable angina pectoris, resistant to medical treatment, were randomized to either active or sham acupuncture in a single‐blind design. Sham acupuncture was defined as the insertion of needles in a point within the same spinal segments as the active acupuncture, but outside the Chinese meridian system. The effect was evaluated from anginal attack rate, nitroglycerin consumption and exercise tests. Compared to patients receiving sham acupuncture the patients receiving active acupuncture increased cardiac work capacity significantly, expressed as dPRP (difference in pressure‐rate‐product between rest and maximum exercise) and maximal PRP during exercise (p<0.001). None of the other variables showed any significant difference between the two groups. Concerning exercise tolerance the median difference was 138 Wmin (95% confidence limits ‐12.5 to 325 Wmin), concerning anginal attack rate the median difference was 29.5% (95% confidence limits 55% to ‐11%) and with regard to nitroglycerin consumption the median difference was 5% (95% confidence limits +67% to ‐44%). No significant effect of sham treatment was observed, no adverse effect was observed. We suggest that acupuncture may improve cardiac work capacity in patients with angina pectoris, refractory to medi

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02770.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTSeventy patients on long‐term diuretic therapy for arterial hypertension and/or congestive heart failure were investigated with regard to skeletal muscle electrolytes and the results of a peroral glucose tolerance test. A significant correlation was observed between the muscle content of potassium and the ability to handle a glucose load. Thirty patients underwent a second set of samples six months after the first one, 23 of whom had a reduction of their muscle potassium content relative to the first biopsy. They simultaneously demonstrated a significant impairment of glucose toleranc

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02771.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTThe effects of β1‐blockade were investigated in 18 hypertensive pregnant diabetic women. The same women served as controls, covering a period just before therapy. The blood pressure was reduced in 14 women (p<0.01). The change in blood glucose homeostasis was statistically not different from the control period. Insulin doses were not affected. The fetal heart rate was affected by therapy, causing a decrease in baseline rate (p<0.05) and in acceleration amplitude (p<0.05). Although the incidence of suspect fetal distress, intrauterine growth retardation and preterm delivery was high, all surviving infants had normal Apgar scores at 5 and 10 min. Perinatal mortality consisted of one stillbirth. Except for respiratory problems, the incidence of neonatal complications was low. All survivors were healthy at follow‐up. We found β1‐blockade to be effective and safe in this group of high‐risk pregnancies, and suggest it as an alternative for anti‐hypertensive therapy in diabeti

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02772.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTThe prevalence of hyperglycaemia and undiagnosed diabetes mellitus was assessed in 214 consecutive patients admitted to the coronary care units with acute myocardial infarction (AMI). On admission, 16 patients (7.5%) had known diabetes, and 19 patients, not previously known to be diabetic, had blood glucose concentrations of ≥9 mmol/1. Fifteen patients survived for 2 months at which time a 75 g oral glucose tolerance test showed diabetes in 9 (60%) and impaired glucose tolerance in 4 (27%). Ten of these 13 patients (77%) with abnormal glucose tolerance had elevated glycosylated haemoglobin (HbA1c) on admission, indicating pre‐existing glucose intolerance or diabetes. The prevalence of undiagnosed diabetes was 4.5% (9/198). However, we may have overlooked undiagnosed diabetes in a small number of patients on admission, since only a random blood glucose<8 mmol/1 rules out diabetes, WHO criteria. Elevated blood glucose in patients with AMI is more likely to reflect a stationary pre‐existing abnormal glucose tolerance than a temporary stress‐induced phe

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02773.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTKetoconazole was administered as a single daily oral dose of 200 mg to 12 patients with chronic mucocutaneous candidosis (CMC) of autoimmune polyendocrinopathy‐candidosis‐ectodermal dystrophy (APECED). The study was double‐blind and placebo‐controlled, with 4‐month therapy periods and crossover, and transfer to open‐label ketoconazole therapy in cases of failure. During the double‐blind trial, all six initially ketoconazole‐treated patients showed a clear clinical and mycological improvement. In contrast there was no change or worsening in the initially placebo‐treated group (p=0.001). Oral candidosis cleared up in all patients, but more rapidly (<2 weeks) in those aged<25 years than in older patients (4–10 weeks;p=0.001). Similarly, nail candidosis improved more rapidly in the younger group. All patients had a recurrence of the candidosis during 36–48 months of post‐therapy follow‐up. The recurrences likewise responded to ketoconazole. In one patient serum transaminase activities were transiently and marginally elevated du

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02774.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTFollowing thyroid resection for nontoxic goitre, 29 euthyroid patients were randomly allocated to no medication or to 0.2 mg levothyroxine daily (17 and 12 patients). The two groups were comparable in age, sex, extent of surgery and thyroid pathology. The patients were free from other endocrine disorders and had no other medication. Serum TSH, T4and T3were measured and T3‐resin test performed preoperatively and 14 days and 3, 6, 12 and 18 months postoperatively. All values were within normal range. Only at the 3‐month follow‐up could statistically significant intergroup differences be observed, with T4higher in the thyroxine‐treated and TSH higher in the untreated group, but the outset values were thereafter regained. The T3values in both groups were slightly reduced immediately after the operation. There was no recurrence of goitre in the 18‐month observation period, and none of the findings suggested that routine thyroxine treatment is of value after resection of nontoxic goitre “

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02775.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY