ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb03383.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:The difficulties encountered in administering D‐penicillamine to 40 patients with rheumatoid arthritis (RA) over a six to 24 month period are recorded. Side‐effects were frequent. Proteinuria occurred in 13 patients (33%) mainly in the fourth to the sixth month. Renal biopsies were performed in six patients and all showed light microscopy abnormalities. Electron microscopy performed in five patients revealed subepithelial deposits in all and in addition some had mesangial and subendothelial deposits. Seven patients (17.5%) developed eight episodes of thrombocytopaenia which was quickly reversed on cessation of treatment or reduction in dosage.On the positive side, there was significant improvement in most parameters of disease activity at six, 12 and 18 months compared to the pretreatment levels, but the results at two years were less impressive. Reduction in steroid dosage was considerable and was greater than half the mean pretreatment dose after two years but the absence of a control group makes the full significance of these uncertain.Patients on high and low dosage regimens were compared over a 12 month period of treatment. Although the differences were not statistically significant, withdrawals and side effects were less frequent in the low dose gr

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb03384.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:During the five years 1971–72 to 1975–76 annual total discharges of patients with a primary diagnosis of asthma from public hospitals in the Hunter Health Region (NSW) fluctuated only slightly. The number of discharges did not reflect consistently the underlying population distribution. Significantly more discharges than expected occurred among people living in the drier inland areas of the Region.Over the same period 65 residents of the Hunter Health Region were certified dead with asthma as the primary cause. In 29, death occurred at one of the Region's public hospitals but only eight were admitted as hospital inpatients primarily with asthma. Of the 65 asthma deaths, 36 (55.4%) occurred outside the Region's public hospit

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb03385.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:The bronchodilator effects of 40 μg ipratropium bromide (I) and 400 μg fenoterol (F) by pressurised aerosol and both drugs in combination were compared with placebo (P) in a double‐blind study in eight patients with chronic, partially reversible airways obstruction. The four treatments were (1) IP, (2) PF, (3) IF and (4) PP, with the second aerosol administered two hours after the first. Both drugs produced significant bronchodilatation for five hours, the response being greater and more rapid in onset with fenoterol. Both drugs in combination (IF) produced significant additive bronchodilatation from three to six hours after fenoterol. This additive effect may have been due to the improved lung function caused by ipratropium bromide and does not imply a synergistic effect. There were no side‐effects reported. The results suggest that both ipratropium bromide and fenoterol are effective bronchodilating agents in patients with chronic a

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb03386.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:The effect on work performance of a single oral dose of the cardio‐selective beta‐adreno‐receptor blocking agent, metoprolol, was compared with an equipotent dose of the non‐selective agent, propranolol, in the same subjects. A number of biochemical and physiological variables including heart rate, oxygen consumption, ventilation, lactate, free fatty acid and glucose levels were measured.Following exercise in the presence of both active drugs, subjects complained of excessive leg fatigue. For the group there was a significant reduction in the total work performed and the maximum heart rate achieved on both drugs.There was a significant correlation between plasma levels of metoprolol, reduction in total work performed and reduction in maximum heart rate. By contrast, after propranolol, there was a wide variation in work performed at a time when the reduction in maximum heart rate was similar for all subjects. This suggests for propranolol that a reduction in heart rate alone is an inappropriate guide to the impairment of work performance.There was a fall in the circulating level of free fatty acids at the end of exercise in the presence of both drugs and it is possible that this biochemical variable contributed to the decrease in work perf

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb03387.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:The hypolipidaemic effect of a low‐fat, low‐cholesterol diet, alone and in combination with weight reduction, has been evaluated in two groups of obese men with hypercholesterolaemia. In 41 men who lost 10.3 kg over 11 months and maintained their lower weight for 23.5 months serum cholesterol fell by 1.68 mmol/l and remained steady at lower weight. In 20 similar men, the controls, whose weight fell by 0.8 kg over 39.5 months, serum cholesterol fell by 0.80 mmol/l. There was a significant linear correlation between change in weight and change in serum cholesterol. The change in serum cholesterol in the weight losers was greater than could be accounted for by change in dietary lipids. Weight reduction and low‐fat, low‐cholesterol diets appear to have a synergistic effect in reducing serum chol

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb03388.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:A study was performed on the family of a child with severe combined immunodeficiency and deficiency of the purine salvage pathway enzyme, adenosine deaminase (ADA). Sixteen relatives over three generations were studied. Erythrocyte ADA levels clearly indicated the heterozygous status of five members. A sixth member, whose erythrocyte ADA level of 48 nmol/hr/mg Hb was within two standard deviations (32) of the mean (76) was shown by ADA determination on platelets to be clearly heterozygous. Similarly, consideration of ADA data of either serum, platelets or lymphocytes only, would have failed to identify all hetero‐zygotes. The survey shows that the identification of phenotype by the indirect means of enzyme level determination is enhanced by the simultaneous study of several tissue

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb03389.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:The relationship between dosage, prothrombin ratio, and steady‐state plasma concentrations of warfarin and warfarin‐alcohol, were determined in 43 patients regularly attending an anticoagulant clinic.The warfarin and warfarin‐alcohol concentrations were determined by a gas chromatographic mass spectroscopic (GC/MS) method. A significant correlation was found between the dose and the plasma level of warfarin. There was no significant correlation between the prothrombin ratio and the dose of warfarin, the steady‐state plasma levels of warfarin or warfarin‐alcohol, or the sum of their plasma concentrations.Measurement of the plasma levels of warfarin and warfarin‐alcohol is likely to be of little help clinically other than to detect failure of compliance or ma

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb03390.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:Spinal cord tumours in patients over 65 years of age are mostly due to metastatic lesions when maximum deficit occurs within eight weeks. Benign tumours have a more chronic progressing course, are mostly in the thoracic region and, unlike younger patients, are overwhelmingly meningiomas. Although uncommon, benign spinal cord tumours should be recognised as a cause of gait deterioration in the elderly patient, as they respond well to surgery.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb03391.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:This study was designed to test the proposition that an optimal age for screening for hypercholesterolaemia (HC) might be defined. The samples of children studied included 200 two‐year‐olds, 385 four‐year‐olds, and 230 primary and secondary children aged from eight to 17 years.The 95th percentile value for total serum cholesterol (TC) was used to define HC in children and to select children for family studies. Four of the 15HC two‐year‐olds had an HC parent with three having a history of early coronary heart disease (CHD). Twenty‐three of the 310 parents sampled had HC, 15 having a family history of early CHD, but only four having an HC child.Family studies were done on 20 HC four‐year‐olds of whom half had a positive family history of premature coronary heart disease (CHD). Half of each group of parents were HC, but probable familial hypercholesterolaemia (FH) was detected only in three parents, environmental causes accounting for the HC of the others.Four primary and five secondary school students were HC, and selected for family studies. A positive family history of CHD was present in two of the primary and all of the secondary students, with five of the seven families having one or more HC parent, one having probable FH.It is proposed that programmes for detecting HC in childhood become valid only from four years of age, and that the presence of a positive family history of early CHD would reduce the proportion of children to be tested to a practical level without significantly impairing the accuracy of the case finding procedure. School entry might provide a suitable time to identify

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb03392.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY