ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1984.tb03749.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1984.tb03750.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract:A sodium loading test was performed in 35 patients presenting with hypertension and hypokalemia. In 14 of these patients, intravenous administration of 0.9% saline (2 I in 4 h) on two consecutive days caused urinary aldosterone excretion to fall to values within the range for normal volunteers. The other 21 patients, in whom urinary aldosterone excretion did not decline following two days of saline loading, or in whom pronounced hypokalemia after the first day of loading precluded further saline infusion, were designated as having primary aldosteronism. Seventeen of this group underwent surgery and discrete adrenal adenomas were found in 16. When serum potassium concentration, plasma renin activity or the relationships of serum potassium to concurrent urinary potassium excretion or of urinary aldosterone excretion to plasma renin activity were used as alternative diagnostic criteria for primary aldosteronism, overlapping of the two groups occurred. It is concluded that measurement of urinary aldosterone excretion after intravenous sodium loading is a useful test in the identification of primary aldosteronism due to aldosterone‐producing adenoma. In this series the saline loading test was more specific in diagnosis than criteria based on serum and urinary potassium, plasma renin activity or unsuppressed aldosterone excretio

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1984.tb03751.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract:The aim of the study was to examine the cross‐sectional relationships between physical fitness and risk factors for coronary heart disease (CHD). Measurements were made of fitness (defined as predicted maximal oxygen uptake), blood pressure, total cholesterol, triglycerides, and glucose in 1500 healthy men and women aged 20 to 65 years. After controlling for the effects of age, physique, smoking, alcohol use and stress, by multiple regression analyses, it was found that fitter men had lower blood pressure, cholesterol, and triglycerides than less fit men, and fitter women had lower blood pressure than less fit women. However, these fitness/risk factor relationships were seen as weak trends, probably of minor clinical importance. It is emphasised that such cross‐sectional data should not be interpreted as support for the popular claim that people who increase their fitness can expect to improve their CHD risk factor sta

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1984.tb03752.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract:The predicted variation of blood pressure and plasma lipid levels, based on association with body weight, age, cigarette smoking and oral contraceptive usage, was examined in 47 000 self‐referred subjects who attended a community programme for coronary risk factor screening. In both sexes, blood pressure and plasma lipid (cholesterol and triglyceride) levels were positively correlated with age and body mass index (BMI, kg/m2). Plasma triglyceride concentrations were positively correlated with cigarette smoking. Partial correlation analysis showed age and BMI to be independently correlated with blood pressure and plasma lipids. Plasma cholesterol and triglyceride levels were correlated with each other independently of the effects of age and BMI. Multiple regression analysis showed age to be a more powerful predictor of blood pressure and plasma lipid levels in females than in males, while BMI was a more powerful predictor of blood pressure and plasma lipid levels in males than in females. Current cigarette smoking did not contribute to the prediction of blood pressure or plasma cholesterol level in either sex, but did predict a 10% higher plasma triglyceride level in both sexes. Oral contraceptive usage did not contribute to the prediction of plasma cholesterol level in multiple regression analysis, but did predict higher plasma triglyceride and blood pressure levels. In view of the high prevalence of overweight people in the Australian community, weight reduction would probably be associated with a significant fall in the risk of coronary heart disease, particularly in male

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1984.tb03753.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract:Twenty cases of culture negative infective endocarditis admitted to the Cardiology Department of Green Lane Hospital from 1959 to 1980 out of a total of 265 cases (7.5%), were analysed retrospectively. Cases were included only when adequate proof of endocarditis was available at surgery or postmortem. Indiscriminate use of antibiotics before taking blood cultures was the most common association with failure to obtain positive cultures, seen in 16 of the 20 patients described. Failure to obtain positive cultures in four cases was attributed to inadequate bacteriologic techniques before 1967. Where no antibiotics were given prior to collecting blood cultures and bacteriologic techniques were adequate, proven culture negative endocarditis was virtually unknown. When antibiotics have been given, repeated blood cultures are recommended following withdrawal of antibiotics for at least four days.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1984.tb03754.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract:A clinical audit of all medical inpatients was undertaken and the appropriateness of admissions and of length of stay was assessed from a clinical viewpoint on 4 separate days within an 11 day period. In addition, the mode of entry to hospital, length of stay of patients, occupancy rate, and the vacancy interval were analysed for all medical patients during the preceding three months.The mean length of stay of medical patients in hospital during this 3 month period was 5.6 days, with an occupancy rate of 93% and a vacancy interval of 0.43 days. Seventy‐four percent of all medical inpatients were admitted through the Accident and Emergency Department (A&E). The short length of stay, high occupancy rate and low vacancy interval indicated that bed usage in the medical wards was efficient.A total of 493 reviews was carried out on 294 individual patients. In 87% of cases, both admission to hospital and length of stay were appropriate on clinical grounds alone. The number of patients whose admission to hospital (11), or length of stay (27) was not justified on medical grounds alone was 38 (13% of total patients). These patients were elderly, or had complex social and psychological problems contributing to their illness. It was concluded that stricter control of admissions or length of stay was unlikely to make a significant number of beds available for other admission

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1984.tb03755.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract:Two female patients revived from fulminant attacks of asthma are described. Ventilatory responses to asphyxia in these patients were 0.70 ± 0.10 I min‐1% SaO2‐1and 0.64 ± 0.21 I min‐1% SaO2‐1(mean ± SEM), respectively. These values were significantly less than the responses of seven normal female subjects (1.54 ± 0.11 I min‐1% SaO2‐1mean ± SEM; p<0.01). Ventilatory responses to hypercapnia of the two patients were in the low normal range. Dopamine‐receptor blockade with prochlorperazine significantly increased the ventilatory response to asphyxia in normal subjects (p<0.05 or less for each subject) but did not alter the depressed responses in the asthmatic patients. In one patient, naloxone in a dose of 400 μg reversed the decreased ventilatory responsiveness; the response to asphyxia was increased from 0.72 I min‐1% SaO‐1to 1.80 I min‐1% SaO2‐1(p<0.01) and the response to hypercapnia was increased from 0.90 I min‐1mmHg‐1to 4.80 I min‐1mmHg‐1(p<0.01). Naloxone had no effect in the second asthmatic patient nor in five normal subjects. Defective chemoreceptor responses to chemical stimuli may play a role in sudden death from asthma; endogenous opioids may mediate t

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1984.tb03756.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1984.tb03757.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract:The effects of corticosteroid administration to eight patients with severe thoracic systemic lupus erythematosus (SLE) were assessed in a prospective study over a mean period of 26 months by serial measurements of respiratory function, ESR, and a clinical score. Initial assessment of respiratory function showed severe restrictive ventilatory defects and impairment of carbon monoxide uptake not wholly attributable to the small lung volumes. ESR and clinical score showed high correlation coefficients with FEV1in all patients, with VC and TLC in seven patients, and with TLCO in four patients, indicating that changes of respiratory function were reflecting the activity of the disease. This study shows that in patients with severe thoracic SLE it is valid to use serial measurements of respiratory function to assess the response to treatment and that pronounced and sustained improvement of respiratory function can be expected.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1984.tb03758.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY