ISSN:0002-9629    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

IntroductionThe character of chest pain (CP) is a major factor determining triage and admission for patients presenting to the emergency department (ED). Previous studies have found atypical descriptions in as little as 10–15% of patients with true myocardial ischemic pain. Atypical descriptions may be more prevalent in the Deep South of the United States because of cultural differences in the semantic description of pain.MethodsA retrospective study of patients presenting to the ED of a southern U.S. urban hospital with enzyme-documented myocardial infarction was conducted to determine the prevalence of atypical CP descriptions. A multivariate analysis of those patients with atypical pain descriptions was conducted to determine the independent demographic factors associated with these descriptions.ResultsIn a total of 77 subjects (56% black; 44% white) meeting the study criteria, 43% were found to have atypical elements in the character of their CP descriptions. Only the black race demographic was found to be significantly correlated with the atypical descriptions. The use of the descriptive term “sharp” accounted for nearly half of the atypical presentations.ConclusionRegional differences in the description of the character of CP may result in misleading portrayals of ischemic heart disease in southern U.S. populations. These differences are associated with a higher prevalence of atypical CP because of semantic distinctions, such as the use of the term “sharp” as a descriptor of acuity rather than character or quality.

ISSN:0002-9629    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

BackgroundSaliva protects the oral mucosa, inhibiting microbial overgrowth. Hyposalivation, therefore, induces multiple oral disorders, although treatment of hyposalivation is very difficult.MethodsA cholagogue, anethole trithione (AT) was administered to patients with symptomatic hyposalivation (xerostomia) caused by senile hypofunction (4 men and 17 women; senile group), medications (6 men and 17 women; drug group), and oral cancer therapy (two men and three women; cancer group). For control groups, an artificial saliva was administered to 45 patients consisting of senile hypofunction (10 men and 16 women), drug-induced xerostomia (3 men and 10 women) and oral cancer therapy-induced xerostomia (four men and two women).ResultsTwo weeks after administration of AT (6 tablets per day), both nonstimulated salivary flow rate (SFR) and stimulated SFR increased in a statistically significantly manner from 0.76 ± 0.41 and 5.18 ± 3.02 to 1.54 ± 1.33 (P<0.05) and 9.07 ± 4.10 mL/10 min (P<0.05), respectively. Of the three groups, the drug group showed the largest increases in both SFRs, from 0.90 ± 0.54 and 6.29 ± 4.12 to 1.69 ± 1.65 and 12.09 ± 5.10 mL/10 min (P<0.05 andP<0.02, respectively). Patients in the control group had almost constant SFRs. After AT administration, the salivary viscosity was, however, mildly decreased and concentrations of secretory-immunoglobulin A, lactoferrin, potassium, and chloride in nonstimulated saliva were almost constant. Corresponding with the increase of salivation, oral discomfort and inflammation were improved or resolved in 41 patients of the AT group within about 4 weeks, whereas improvement was observed in only nine patients of the control group.ConclusionsThese results indicate that AT sufficiently stimulates salivation and improves xerostomia.

ISSN:0002-9629    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

BackgroundWeight gain is a frequent consequence of smoking cessation. Leptin, the protein product of theobesegene, seems to regulate appetite and body fat stores. The purpose of this study was to assess changes in circulating leptin levels and lipid metabolism during nicotine abstinence (NA) and their role in postcessation weight gain.MethodsSix sedentary, weight-stable, nonobese adult smokers were studied before and after 7 days of NA while following a weight-maintenance diet of standard composition. All subjects refrained from smoking overnight (as assessed by breath CO) and were instructed to chew nicotine polacrilex gum (4 mg) hourly from 7:00 AM to 8:00 PM [nicotine intake (NI) day]. Venous blood samples were collected at 7:00 AM (after an overnight fast) and 5:00 PM (pre-supper) on NI day and again after 7 days of NA.ResultsBody weight did not change after 7 days of NA (72.0 ± 2.8 versus 71.8 ± 2.7 kg). Serum cotinine levels declined from 207 ± 40 ng/mL during NI to undetectable levels during NA (P<0.01). Fasting plasma leptin was similar during NI and NA (5.7 ± 1.4 versus 6.4 ± 1.9 ng/mL;P= NS). Moreover, plasma concentrations of glucose, insulin, and free fatty acids were unaffected by 7 days of NA. Although plasma triglycerides, total cholesterol, and low-density lipoprotein cholesterol were similar during NI and NA, high-density lipoprotein cholesterol increased by 15% after 7 days of NA (P< 0.05).ConclusionsIn this group of nonobese, adult smokers consuming an isocaloric diet, NA for 7 days did not affect body weight or circulating concentrations of leptin, glucose, insulin, or free fatty acids. In contrast, HDL cholesterol increased significantly after NA. These results indicate that under controlled dietary conditions, changes in leptin expression do not contribute to the weight gain that commonly accompanies smoking cessation.

ISSN:0002-9629    

出版商:OVID    

年代:1999

数据来源: OVID