bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunosuppression and the Additive Effect of Plasma Exchange in Treatment of Rapidly Progressive Glomerulonephritis
Authors: Thysell H. , Bygren P. , Bengtsson U. , Lindholm T. , Norlin M. , Jonsson M. , Brun C. , Larsen S. , Jørgensen F. , Sjöholm A. , Laurell A.‐B.
Published: August 2010

ABSTRACT. Attempts were made to evaluate the separate effect on kidney function of immunosuppressive treatment (IS) and plasma exchange (PE) in 27 patients with rapidly progressive glomerulonephritis (RPGN). Twenty‐four of the patients were treated with PE. Initial IS was supplemented with PE within 6–12 days in 5 patients, and after at least 14 days in 13. Because of suspected septicemia, 2 patients were first treated with PE, and IS was not initiated until the possibility of septicemia had been excluded. In 4 severely ill patients with rapid clinical deterioration, both treatments were started simultaneously. Twenty patients improved during one or both treatments, 4 with IS alone, 2 with IS and doubtfully with PE, 3 with IS and probably also with PE, 5 both with IS and PE and one with PE alone. In 5 patients the individual effects of IS and PE could not be evaluated. In another 2 patients the combined treatment seemed to influence the course favourably. In the remaining 7 patients the effect of the treatment was doubtful or nil. Two further patients with Goodpasture's syndrome were treated. They were admitted late, and both kinds of treatment were instituted simultaneously. One of them died in respiratory insufficiency, the other remained oliguric while the pulmonary changes faded. Thus, PE added a postive effect to IS in several patients with RPGN. The treatment had few and mostly mild side‐effects.
Oral Contraceptives, Smoking and Risk of Myocardial Infarction in Young Women
Authors: Salonen Jukka T.
Published: August 2010

ABSTRACT. The use of oral contraceptives (OC) and smoking habits were studied by using a questionnaire in a random population sample of women from two counties of Eastern Finland in 1972. The participation rate was 95%. Data on use of OC and smoking were collected for 2 653 women aged 35–49 years. During the next seven years, 27 of them had developed an acute myocardial infarction (AMI). Smokers had a 2.6‐fold (95% confidence interval (CI)=1.2–6.0) crude risk of developing AMI compared with non‐smokers. Women taking OC had a 1.3‐fold (95% CI=0.4–6.9) risk of developing AMI compared with those who did not. Women who both smoked and used OC had a 7.2–fold (95% CI=2.1–24.7) risk of AMI compared with non‐smokers and non‐users of OC. The results indicate that use of OC is associated with an excessive risk of AMI among female smokers.
Nutritional Status of Medical Patients on Emergency Admission to Hospital
Authors: Albiin Nils , Asplund Kjell , Bjermer Leif
Published: August 2010

ABSTRACT.The nutritional status was assessed in 75 consecutive patients acutely admitted to a general medical ward. Weight‐for‐height, triceps skinfold thickness, arm muscle circumference, plasma albumin and serum transferrin were used as nutritional indicators. By combining abnormalities in two or more of these variables, we found obesity in 9% and undernutrition in 22% of the patients on admission. Energy deficiencies as well as acute and chronic protein undernutrition were observed. Age over 75 years, lack of own teeth and a reason for admission other than circulatory disorders or diabetes were tentatively identified as risk factors for undernutrition‐some of them conceivably interdependent. Living conditions and regular medication seemed to be less important determinants in this group of patients. We conclude that undernutrition is prevalent among hospitalized medical patients in Sweden as in other industrialized countries. Patients with “hospital malnutrition” are partly recruited from a population of malnourished elderly people outside the hospital. Adequate nutritional support is an essential objective of hospital care in patients with medical disorders.
Hypercalcemia due to Primary Hyperparathyroidism or Malignant Disease
Authors: Kvetny J. , Orthman‐Brask H. , Frederiksen P. K. , Jest P. , Jensen E. , Jacobsen J. G.
Published: August 2010

ABSTRACT. The cortisone suppression test and some biochemical tests were evaluated in 13 patients with hypercalcemia due to primary hyperparathyroidism (PHP) and in 10 with hypercalcemia due to a malignant disease. The biochemical tests revealed that serum chloride was significantly raised in patients with PHP compared to patients with malignant diseases, whereas no differences were observed with regard to the serum values of corrected calcium, serum phosphate, chloride/phosphate ratio, HCO3‐. Although serum values of parathyroid hormone were higher in patients with PHP, a considerable overlap was observed between values in the two patient groups. Corrected serum calcium values were significantly suppressed during cortisone administration in patients with malignant disease compared to patients with PHP, whereas prednisolone had no suppressive effect. The positive predictive value of the test was 80.0% and the negative predictive value 66.7%. We conclude that there is still no entirely reliable method to distinguish between hypercalcemia due to PHP or malignant disease.
Patterns of Proteinuria and Circulating Immune Complexes in Febrile Patients
Authors: Sølling J. , Sølling K. , Mogensen C. E.
Published: August 2010

ABSTRACT. Circulating immune complexes (CIC) were detected in 8 of 15 patients with fever due to non‐renal infections. Elevated urinary albumin and β‐2‐microglobulin excretion rates were found during the febrile period compared to the levels two days after normalization of the temperature. No relationship could be demonstrated between CIC and the excretion rates of albumin and β‐2‐microglobulin or the albumin/β‐2‐microgIobulin ratio. Thus we have not been able to confirm the hypothesis that the glomerular type of proteinuria is caused by immune complexes.
Isolated Thyrotropin Deficiency in a Man with Narcoleptic Attacks
Authors: Nygren A. , Röjdmark S.
Published: August 2010

ABSTRACT. A patient with narcoleptic attacks and isolated thyrotropin deficiency is presented. Substitution with l‐thyroxine did not relieve his narcoleptic attacks. Deficiency, in the central nervous system, of the ergotropic substance thyrotropin‐releasing hormone (TRH) might have caused the thyrotropin deficiency and contributed to the narcoleptic attacks. However, prolonged oral medication with TRH, in doses of 120 or 240 g daily, failed to attain any significant relief. Although this does not exclude TRH unresponsiveness due to absent or defective TRH receptors, the true cause of the disease remains to be elucidated.
Paraneoplastic Polyneuropathy Associated with a Carcinoid Tumor of the Cecum
Authors: Sipilä R. , Leinonen H. , Juntunen J.
Published: August 2010

ABSTRACT. Rapidly progressing, fulminant polyneuropathy in connection with a carcinoid tumor in the cecum was diagnosed in a female patient. After excision of the tumor a clear remission took place.
Coexistent Hereditary Haemorrhagic Telangiectasia and Primary Thrombocythaemia—Coincidence or Syndrome?
Authors: Cronstedt Jean , Brechter Carl , Carling Lasse
Published: August 2010

ABSTRACT. Two patients with coexistent hereditary haemorrhagic telangiectasia (HHT) and primary thrombocythaemia (PT) are presented. In one of them, both diseases were detected at the same time. In the other, signs of HHT were present 20 years prior to the diagnosis of PT. Both patients had recurrent gastrointestinal haemorrhage with consequent anaemia, and multiple gastric telangiectases were demonstrated endoscopically. Persistent and severe haemorrhage from gastric telangiectases in one of the patients was successfully controlled by endoscopic monopolar electrocoagulation. The very high platelet counts were reduced with melphalan in one patient and with busulfan in the other. The degree of severity of both disorders was parallel in both cases. We suggest that the coexistence of these two rare disorders in one and the same patient may represent a syndrome that could be more common than hitherto known.
The Quantitative Liver Function as Measured by the Galactose Elimination Capacity
Authors: Lindskov J.
Published: August 2010

ABSTRACT. Quantitative liver function was estimated by determination of the galactose elimination capacity (GEC) in 29 patients with steatosis, 50 with cirrhosis and 42 control patients without clinical history or signs of liver disease. In patients with steatosis and cirrhosis, clinical signs of liver disease were recorded and the most common liver tests were carried out. The degree of histological changes was investigated in needle liver biopsies performed in a close relation to the GEC determinations. A positive correlation between GEC and body weight and body surface area was observed in all three patient groups. GEC (absolute value, per kg body weight and per m2 body surface area) was significantly different (p<0.001) between the three groups, but was without diagnostic value due to a broad scattering of results in each group. This may be due to methodological errors in the determination of GEC, but also to the large biological variation in normal man and the pathophysiological conditions in patients with liver disease. Neither in patients with steatosis nor in patients with cirrhosis could significant relations be found between GEC and clinical signs of liver disease or the degree of severity of histological changes assessed semiquantitatively. In patients with cirrhosis but not in patients with steatosis, GEC was significantly correlated with the majority of the most commonly utilized liver tests.
The Quantitative Liver Function as Measured by the Galactose Elimination Capacity
Authors: Lindskov J.
Published: August 2010

ABSTRACT. The quantitative liver function, measured by the galactose elimination capacity (GEC), was determined repeatedly in 44 patients with cirrhosis during the course of the disease. After a median observation period of 57 months (range 28–85) 17 had died from liver insufficiency. GEC was found to be of prognostic value, as classification of the patient series on the basis of the median value of two extreme prognostic groups indicated that the survival of patients with GEC >1.37 mmol·min‐1 at entry was significantly larger than of patients with GEC below that value (p<0.05). The prognostic values of serum albumin and prothrombin were of the same order of magnitude. At repeated examinations during the course of the disease, the survivors always had higher GEC values than those who died from liver insufficiency. Among those who survived and those who died there were patients with both increasing and decreasing GEC values, but no significant changes were observed within the groups. The individual changes in GEC can result from changes in the balance between liver cell necrosis and regeneration, but the possibility cannot be excluded that changes are due to methodological problems in the determination of the quantitative liver function as measured by GEC.
Stroke in an Isolated Population
Authors: Joensen Poul
Published: August 2010

ABSTRACT. In a retrospective study covering 14 years (1962–75), the annual incidence of stroke in the isolated population of the Faroes (approx. 40000 inhabitants) was 45.7 per 100000 in the age range 15–65 years. The type of stroke was subarachnoid haemorrhage in 34 cases, and other types of stroke were found in 111 cases. The incidence of stroke in this study was lower than in Denmark, Finland, Sweden and the USA. There was no significant sex difference (males 43.0, females 48.3) (p>0.05). It is pointed out that dietary habits on the Faroes differ from those in other Scandinavian countries.
Plasma Volume and Plasma Volume Distribution at Rest, during Muscular Work, Cold Pressure Test and Psychological Stress in Male Offspring from Families with Heavy Aggregation of Hypertension
Authors: Ohlsson O. , Henningsen N. C. , Hood B.
Published: August 2010

ABSTRACT. Total and central plasma volume was measured in 51 male offspring of hypertensive individuals belonging to families with a history of essential hypertension for at least two generations. They were compared to 38 age‐matched individuals without known hypertension in their families for at least two generations. Central plasma volume was determined at rest and during muscle work, cold pressure test and psychological stress. The offspring had significantly lower total plasma volume than the controls. Central plasma volume was equal in offspring and controls. The quotient central/total plasma volume was thus higher in offspring than in controls, and the difference was statistically significant during psychological stress and dynamic muscle work. Possible reasons for the differences between offspring and controls are an increased transcapillary escape of plasma, an increased quotient intracellular/extracellular fluid and/or increased tone of the capacitance vessels.
Venous Volume and Blood Flow in Hand at Rest and during Psychological Stress in Male Relatives to Hypertensive Patients
Authors: Ohlsson Ola
Published: August 2010

ABSTRACT. A total of 19 male relatives to hypertensive individuals were examined with regard to blood flow and venous volume in the hand at rest and during a psychological stress test. They were compared to 19 male controls without heredity for hypertension. There were no significant differences between the groups in hand blood flow or venous volume either at rest or during the test. The increase in vascular resistance during psychological stress was significantly higher in relatives than in controls. Possible mechanisms behind the differences in arterial vascular reactivity between the groups are discussed.
Malignant Arrhythmias during Strenuous Work in Four Young Men
Authors: Rasmussen Verner
Published: August 2010

ABSTRACT. Four young healthy men (17–25 years old) experienced life‐threatening arrhythmias during physical exertion. All were successfully resuscitated. One died later. Electrophysiological studies disclosed a lack of normal conduction delay and abnormal His‐Purkinje properties indicating congenital malformation of the atrioventricular (AV) node in one patient and the rare and potentially dangerous combination of an accessory AV pathway and intraatrial conduction delay with liability to dissimilar rhythms and fibrillation in the atria in another. The conduction system functioned normally in the other two. One of the latter two patients had cerebral damage during prolonged resuscitation and experienced repeated epileptic spells until he died unexpectedly. Autopsy revealed scarring of unknown origin in the interventricular septum. The other had stress‐induced ventricular ectopy, which gradually diminished and disappeared in a few weeks. The etiology of the latter two is suggested to be ischemia. It is warranted to point out the possible danger of maximal physical strain even in young people.
Can Left Main or Proximal Left Anterior Descending Coronary Artery Disease Be Assessed by Non‐Invasive Means?
Authors: Andersen Kai , Vik‐Mo Harald , Omvik Per
Published: August 2010

ABSTRACT. One hundred consecutive patients with angina pectoris referred for coronary arteriography were studied prospectively for non‐invasive assessment of left main (LMCA) or proximal left anterior descending coronary artery (proximal LAD) disease. Evaluation of echocardiography interventricular septal motion, history and exercise test response could not identify the patients with these specific lesions. It is concluded that LMCA and proximal LAD disease still remain largely unpredictable by non‐invasive means.
Herpesvirus Antibodies and Vascular Complications in Essential Hypertension
Authors: Kristensen Bent Ø. , Andersen Paul L. , Vestergaard Bent F. , Andersen Hans M. K.
Published: August 2010

ABSTRACT. Antibodies against herpes simplex virus (HSV) and cytomegalovirus (CMV) were examined in sera from 132 patients with essential hypertension and 54 normotensive healthy subjects of the same age and sex. Prevalences of HSV and CMV antibodies (titre ≥4) were equal in patients and controls. A HSV antibody tire ≥4 was found in 39.5% (17/53) of patients with WHO stage III hypertension, in 26.2% (22/85) of patients with stage I–II hypertension, and in only 9.4% (5/54) of normotensive subjects (p<0.0005). The HSV antibodies were mainly of type 1. No association between CMV antibodies and vascular complications could be demonstrated.
Normal Growth Hormone Secretion is Rare after Microsurgical Normalization of Growth Hormone Levels in Acromegaly
Authors: Hulting Anna‐Lena , Werner Sigbritt , Wersäll Jan , Tribukait Bernhard , Anniko Matti
Published: August 2010

ABSTRACT. The effect of microsurgery on growth hormone (GH) secretion was studied in 34 patients with acromegaly. All patients showed enlarged sella volumes according to encephalography and macro‐adenomas at surgery. Preoperative GH levels were elevated in all 34 patients and 14 had concomitant hyperprolactinemia. There was a correlation between basal GH levels and sella size. Visual field defects, suprasellar extension, long duration of the disease, hyperprolactinemia and aneuploidy were noted in patients with low as well as high levels of GH pre‐operatively. The average reduction of GH levels in the total series was 71 ± 21% (mean ± SD). A notably similar reduction of GH levels was seen regardless of preoperative GH levels, concomitant hyperprolactinemia, visual field defects, size of the adenoma, invasive growth or increasing experience of the surgeon. Therefore, normal GH levels after surgery were reached mainly in patients with moderate GH increments preoperatively. GH levels were normalized by surgery in 15 patients but only four of these showed normal GH response to TRH and l‐dopa tests. Thus, only four patients (12%) fulfilled these criteria for cure of GH homeostasis.
Goodpasture's Syndrome in Twins
Authors: Simonsen H. , Brun C. , Thomsen O. Frakjaer , Larsen S. , Ladefoged J.
Published: August 2010

ABSTRACT. Goodpasture's syndrome occurred within 4 months of each other in identical twin sisters aged 12. In one of them the pulmonary haemorrhages were successfully treated with plasmapheresis. Hereditary as well as environmental factors may contribute to the development of this uncommon disorder.
Two‐Dimensional Echocardiography in the Diagnosis of Hemorrhages in a Left Atrial Myxoma
Authors: Bryhn Morten , Gustafson Arne , Stubbe Ingo
Published: August 2010

ABSTRACT. Two‐dimensional echocardiography in a patient with left atrial myxoma showed an echo‐free area in a left atrial mass which corresponded to hemorrhages found in the surgically removed tumour. Atypical features of the latter were elucidated by simultaneous recording of two‐dimensional and M‐mode echocardiograms.
Dietary Fibre in Type II Diabetes
Authors: Asp N.‐G. , Agardh C.‐D. , Ahrén B. , Dencker I. , Johansson C.‐G. , Lundquist I. , Nyman M. , Sartor G. , Scherstén B.
Published: August 2010

ABSTRACT. Recent studies have indicated that diets rich in digestible carbohydrates and dietary fibre might be beneficial in the regulation of type II non insulin dependent diabetes (NIDD). Addition of the gel forming type of dietary fibre such as pectin and guar gum to meals or glucose solutions reduces postprandial glucose and insulin response. Addition of cereal fibres in the form of bran seems to have long term beneficial effect improving glucose tolerance. Little is known, however, concerning effects of dietary fibre naturally occurring in food on postprandial glucose and hormone response. In the present study we prepared two breakfast meals which were similar regarding digestible carbohydrates but differed in their dietary fibre content. One of the meals, including whole grain bread and whole apples, contained 8.4 g of dietary fibre, and the other one, containing white bread and apple juice, 3.1 g. When given to eight NIDD, the fibre rich breakfast gave significantly lower blood glucose increment during the three hours following ingestion. The results indicate that foods rich in dietary fibre might be useful in the regulation of type II diabetes.
Dietary Supplementation of Fibre (Lunelax®) as a Mean to Reduce Postprandial Glucose in Diabetics
Authors: Sartor Gunnar , Carlström Sven , Scherstén Bengt
Published: August 2010

ABSTRACT. The postprandial glucose concentrations after a standardized breakfast of 12 type II diabetics were followed and the effect of supplementation of a fibre‐containing bulk‐purgative (Lunelax®) to the meal was investigated. It was found that addition of Lunelax® reduced the mean increment glucose concentration with about 9%. The patients reported that Lunelax was convenient to take.
Effect of Administration of Activated Charcoal and Fibre on Absorption, Excretion and Steady State Blood Levels of Digoxin and Digitoxin. Evidence for Intestinal Secretion of the Glycosides
Authors: Reissell P. , Manninen V.
Published: August 2010

ABSTRACT. The effects of activated charcoal and fibre on absorption and stationary plasma levels of digoxin and digitoxin have been studied. The effect of fibre alone is small but an interactive effect on absorption may occur if fibre and digoxin are ingested simultaneously. Charcoal effectively decreases glycoside absorption even when administered after the glycosides. During maintenance therapy with digoxin or digitoxin, charcoal administration decreased the glycoside plasma levels by 31.2% and 18.3% respectively. It is suggested that even digoxin may have a significant biliary excretion and enterohepatic circulation or that this glycoside has a significant intestinal secretion. The therapeutic implication of this study is that charcoal may be of value, not only in the management of acute glycoside poisoning, but also in some cases of more chronic intoxication.
Aprotinin in Acute Pancreatitis: Effect on the Plasma Kallikrein‐Kinin System
Authors: Sipilä Risto , Louhija Antti
Published: August 2010

ABSTRACT. The effect of aprotinin (»Trasylol») on the plasma kallikrein‐kinin system was studied in 44 patients with acute pancreatitis. 21 of these patients received aprotinin whie 23 did not receive such treatment. It is concluded that an activation of the plasma kallikreinkinin system occurs in acute pancreatitis. Aprotinin was not found to inhibit this activation.
HIGH BLOOD PRESSURE IN WOMEN
Authors: Sigurdsson Johann A
Published: August 2010

The aim of this study was mainly to determine the prevalences of primary and secondary arterial hypertension in middle‐aged women and of symptoms, signs and metabolic effects of increased blood pressure per se or antihypertensive treatment, and to study the prognosis for women with hypertension. The study was part of a comprehensive longitudinal population study of middle‐aged women which started as a cross‐sectional study in 1968–69 (1462 participants, participation rate 90.1%). The same sample was re‐studied in 1974–75 (1302 participants, participation rate 89.1%) and in 1980–81 (1154 participants, participation rate 78.9% of those studied in 1968–69).

Arterial hypertension was defined as systolic blood pressure ≥ 160 mm Hg or diastolic blood pressure > 95 mm Hg (phase 5) or both. Women on anti‐hypertensive treatment were also considered hypertensive irrespective of the blood‐pressure levels. Altogether 192 women (13.1%) were considered to be untreated hypertensives and 68 women (4.7%) were on antihypertensive treatment at the time of the initial study. Secondary hypertension was found to account for 4.6% and surgically curable hypertension less than 1% of all causes of hypertension.

Headache and dizziness were more often reported by those women who were on antihypertensive drugs, but when studied longitudinally only dizziness appeared as a new symptom more often in those who started antihypertensive treatment compared to the non‐hypertensive women (p < 0.05). It was especially common in those who started to take diuretics. Thirtyfour previously untreated women started taking diuretics and 52 β‐blockers as the sole antihypertensive drug after the initial study and were still on these drugs in 1974–75. An increase in serum triglyceride concentration was found in women started on β‐blcckers and a slight increase in serum uric acid in those started on diuretics. Serum cholesterol and blood glucose were unimpaired. There was an overrepresentation of diabetes nellitus in women starting antihypertensive treatment during the 12‐year follow‐up period (p < 0.001, relative risk 6.0). The increased incidence of diabetes mellitus could not be related to any particular antihypertensive drug.

A 12‐year follow‐up of the population sample with respect to morbidity from cerebrovascular and cardiovascular diseases and total mortality is presented. Neoplasms were the most common cause of death. The morbidity from myocardial infarction and stroke and the total mortality were higher than expected in the group of women who were already on antihypertensive treatment at the time of the initial study, but no higher than expected in women whose hypertension was discovered in 1968–69 and who were offered continuous medical care throughout the period (expected figures calculated from age‐specific incidence rates in the total population sample).

The preventive implications seem obvious. Early detection of arterial hypertension and continuous medical care, including antihypertensive treatment when needed, seem to lengthen the life of women without diminishing their quality of life.
Effects of a Formalized Diabetes Education
Authors: Karlander Sven‐Gunnar , Kindstedt Karin
Published: August 2010

A previous study of patients attending a diabetic out‐patient clinic indicated that their metabolic control was inadequate and their knowledge of diabetes and diabetes management was generally low. In an attempt to improve the situation, we organized a five‐day education programme comprising formal lessons about diabetes, diet and nutrition. Altogether 83 patients completed the course. The test scores before and one year after the course indicated that the patients' knowledge had improved. Metabolic control, however, was essentially unchanged at the follow‐up.
Relationship between Bone Mineral Content and Frequency of Postmenopausal Fractures
Authors: Jensen Grethe Finn , Christiansen Claus , Boesen Jens , Hegedüs Victor , Transbøl Ib
Published: August 2010

To elucidate the relationship between bone mineral content (BMC) and the frequency of postmenopausal fractures, we performed an epidemiologic investigation in a representative sample of 70‐year‐old women. Anamnestic data concerning postmenopausal fractures due to minor trauma were recorded and lateral X‐rays of the spine were taken for evaluation of spinal fractures. BMC was measured by 125I photon absorptiometry. The 285 women studied were allocated into quintiles according to their BMC value. In 77 women, there were 131 definite osteoporotic fractures (i.e., spinal crush, and fracture of the hip, proximal humerus, and distal forearm), and in 48 women, there were 162 other non‐violent fractures (i.e., spinal wedge and other long bone fractures). The frequencies of osteoporotic fractures varied inversely with the mean BMC values for each quintile (r=0.959, p<0.01). The difference in frequency of osteoporotic fractures between the first and fifth quintiles was highly significant (p > 0.001). In contrast, other non‐violent fractures appeared to be unrelated to BMC. It is concluded that low BMC levels predispose to osteoporotic fractures.
Drunkenness, Hangover, and the Heart
Authors: Kupari Markku
Published: August 2010

Cardiac effects of ethanol ingestion (1.75 g/kg within 3 hours) were examined in 8 healthy males by echocardiography and systolic time intervals in a controlled study. Heart rate (HR) was increased by 15% (p<0.05) during intoxication when blood ethanol (mean±SD) was 33.7 ±4.1 mmol/l. Left ventricular (LV) end‐diastolic dimension was simultaneously shortened by 4% (p<0.01) and LV end‐systolic dimension by 3% (p<0.05). Stroke volume was reduced by 12% (p<0.05). Most subjects experienced hangover symptoms 12 hours after the beginning of ethanol intake; blood ethanol was 8.8 ± 4.0 mmol/l. At this time, HR was raised by 17% (p<0.05), ejection fraction by 7% (p<0.05), and circumferential fiber shortening velocity by 19% (p<0.01); total peripheral resistance was decreased by 17% (p<0.001). The resultant increase in cardiac output amounted to 22% (p<0.01). In short, the main effect of ethanol at modest blood concentrations was to reduce LV preload without detectably impairing myocardial performance. Hangover was characterized by vasodilation as well as intensified LV myocardial and pump performances.
Alcohol and the Heart
Authors: Kupari Markku , Eriksson C. J. Peter , Heikkilä Juhani , Ylikahri Reino
Published: August 2010

To evaluate the hemodynamic changes related to alcohol flush, the effects of ethanol intake (0.5 g/kg) were studied by echocardiography and systolic time intervals in 10 Finnish and 9 Japanese healthy volunteers. In 5 Japanese subjects, post‐drink facial flush was associated with elevated blood acetaldehyde (peak levels 20–83 μmol/l) and marked cardiocirculatory stimulation. Heart rate was increased directly post ingestion by 65% (p<0.01), stroke index by 23% (p<0.05), and cardiac index by 106% (p<0.05). Diastolic blood pressure was simultaneously decreased by 23% (p<0.05), peripheral vascular resistance by 54% (p<0.01), and circumferential wall stress by 22% (p<0.05); ejection fraction was raised by 26% (p<0.01). The other Japanese and the Finnish subjects had no detectable acetaldehyde in blood after ethanol ingestion. The average hemodynamic alterations in them were similar in direction to the changes presented above, but quantitatively 6–10 times smaller (p<0.005 for each of these variables). Thus, in Orientals with genetically defective acetaldehyde oxidation, ingestion of even small amounts of alcohol evokes intense enhancement of left ventricular function, probably because of acetaldehyde‐induced catecholamine release and peripheral vasodilation.
Nitroglycerin Ointment Effective for Seven Hours in Severe Angina Pectoris
Authors: Kala Risto , Hirvonen Petri , Gordin Ariel , Sundberg Stig , Auvinen Juha , Halonen P. I.
Published: August 2010

ABSTRACT The efficacy and tolerability of nitroglycerin (NTG) ointment were studied in 80 male patients with severe angina pectoris. Two symptom‐limited exercise tests were performed on successive days after application of an ointment containing 15 mg NTG or a placebo (P) ointment. The patients were assigned to 4 groups. The study was conducted in a double‐blind, cross‐over manner. The total amount of work performed was higher in all groups on NTG (46–70%) compared to P ointment. The difference was statistically significant (p<0.001) at all points of time from 0.5 to 7 hours. The ST segment depression in ECG at the end of the exercise test was slightly greater on P than on NTG, but the difference was statistically significant only in the 3‐hour group (p<0.01). The frequencies of headache and dizziness were 35% and 16%, respectively, on NTG. Eight patients (10%) reported that headache was severe enough to prevent regular use of NTG ointment. NTG ointment is effective, has a long duration of action and is relatively well tolerated by patients with severe angina pectoris.
Symptoms and Signs in Relation to Blood Pressure and Antihypertensive Treatment
Authors: Sigurdsson Johann A. , Bengtsson Calle
Published: August 2010

ABSTRACT Altogether 1462 middle‐aged women aged 38–60 participated in a population study which was carried out in Göteborg, Sweden in 1968–69. Of these women, 1302 were re‐investigated six years later in a follow‐up study. Studied cross‐sectionally, headache and nycturia were found to be more common in both untreated and treated hypertensives than in a non‐hypertensive reference group. The prevalences of headache seemed to be U‐shaped when related to the BP levels, with the highest prevalences in the lowest and highest quintiles of BP levels. In the longitudinal study, headache did not occur more often in those women who had started antihypertensive treatment than in the others. Dizziness as a new symptom occurred more often in women who had started to take antihypertensive drugs than in those who had not, and was more common in those who had started taking diuretics than in those starting on β‐blockers. The prevalences of eyeground phenomena and ECG changes seemed to increase linearly with increasing BP levels. It is concluded that some symptoms and signs are related to BP levels, and some of the symptoms in hypertensive women may also be related to antihypertensive treatment as such and to the type of antihypertensive treatment given.
Cause of Death in Relation to Social and Alcoholic Problems among Swedish Men Aged 35–44 Years
Authors: Wilhelmsen Lars , Elmfeldt Dag , Wedel Hans
Published: August 2010

ABSTRACT There have been conflicting reports concerning the relationship between increased alcohol intake and mortality from ischaemic heart disease. In this investigation, social register data also containing life‐long registration data for alcoholic intemperance were related to cause of death for 302 men aged 35–44 in 1968–74. A random population sample of 940 male survivors of the same age was used for comparison. “Social problems only” were less common for the deceased, irrespective of cause of death, than for the controls. Registration for alcoholic problems was significantly more common for ischaemic heart disease, accidents, suicide and “other deaths” but not for cancer. The variables “detained by the police for drunkenness” and “in prison for crime” showed similar associations. Possible explanations are discussed, especially the association between alcoholic intemperance and death from ischaemic heart disease. The most probable mechanism is effects on the myocardial cell enzyme functions with following arrhythmias in subjects susceptible to malignant arrhythmias due to coronary artery disease and myocardial ischaemia.
Lupus Band Test in Uninvolved Oral Mucosa in Systemic Lupus Erythematosus
Authors: Jonsson Roland , Nyberg Gudrun , Kristensson‐Aas Aud , Westberg N. Gunnar
Published: August 2010

ABSTRACT In 42 patients with systemic lupus erythematosus, clinically normal oral mucosa was investigated with direct immunofluorescence technique for the presence of immunoglobulins G, A and M and complement factor C3 in the mucosal basement membrane zone (the lupus band test, LBT). Punch biopsies were performed in the posterior part of the hard palate (n = 39) or the lower labial mucosa (n = 3). The immunopathological observations were compared with clinical and serological data. The LBT was positive for IgM in 45% of the patients and trace amounts of IgM were found in another 19%. In 7 cases (17%) either IgG, IgA or C3 were found in addition to IgM and these patients all had a severe form of the disease, while the presence of IgM only was not correlated to clinical parameters.
Value of Liver and Spleen Aspiration Biopsy in Malignant Diseases when these Organs Show no Signs of Involvement in Sonography
Authors: Jansson S.‐E. , Bondestam S. , Heinonen E. , Gröhn P. , Vuopio P.
Published: August 2010

ABSTRACT To determine whether an aspiration biopsy of liver and/or spleen is likely to reveal a clinically silent malignant infiltration, fine‐needle aspiration biopsies were carried out in 180 patients with a diagnosed malignancy in whom neither the liver nor the spleen gave signs of involvement in sonography. Few, if any, findings were positive in patients with cancer or Hodgkin's disease. In non‐Hodgkin lymphoma, about 25% of the biopsies were positive for malignancy or aroused suspicion of malignancy. We conclude that fine‐needle aspiration biopsies of the liver and spleen may be of value in the clinical follow‐up of non‐Hodgkin lymphoma.
Cefotaxime versus Ampicillin, Methicillin and Netilmicin in Combination for Treatment of Febrile Episodes in Patients with Haematologic Malignancy
Authors: Friis H. , Hoffmann S. , Hansen M. , Hansen M. Mørk , Justesen T. , Nissen N. I.
Published: August 2010

ABSTRACT A prospective, randomized trial comparing treatment of 61 febrile episodes with cefotaxime (CTX) versus a combination of ampicillin, methicillin, and netilmicin (AMN) was carried out in 58 patients with leukaemia or malignant lymphoma, of whom 28 had a granulocyte count of 500×106/I. The overall response frequency was 63% for CTX against 49% for the AMN combination, the latter figure being lower than generally reported in the literature. The difference was not statistically significant. In 21 episodes pathogens were isolated, 16 of them from the blood. All isolated bacteria but one, a strain of Bacteroides fragilis, were fully sensitive to at least one of the three antibiotics in the combination, and all but one, a strain of Listeria monocytogenes, were fully sensitive to CTX. These results indicate that CTX seems to be a promising alternative as monotherapy for empiric treatment of febrile episodes in patients with haematologic malignancies. Further investigations will, however, be required before completely rational choices between mono and combination therapy of febrile episodes in immuno‐suppressed patients can be made.
Increased β‐Thromboglobulin in Essential Hypertension: Interactions between Arterial Plasma Adrenaline, Platelet Function and Blood Lipids
Authors: Kjeldsen Sverre Erik , Gjesdal Knut , Eide Ivar , Aakesson Ingvar , Amundsen Ruth , Foss Olav Per , Leren Paul
Published: August 2010

ABSTRACT Twenty‐three 50‐year‐old men with untreated, essential hypertension had elevated plasma concentrations of the platelet release product β‐thromboglobulin (BTG) compared to 14 age‐matched control men (p<0.01). BTG correlated with arterial plasma adrenaline concentrations in the hypertensive (r=0.44, p<0.05), normotensive (r=0.73, p<0.01) and combined group (r=0.51, p<0.01). Significant correlations (p<0.05) between BTG and cholesterol (LDL + VLDL fraction) were observed both in the hypertensive and the normotensive group. In the hypertensive group arterial adrenaline correlated with cholesterol (LDL + VLDL) (p<0.05). These findings are consistent with increased platelet activity in middle‐aged men with essential hypertension, and may indicate that plasma adrenaline influences platelet function. The risk factors for coronary artery disease (blood pressure, lipid status, stress as evidenced by catecholamine release and platelet function) were positively related. Measurement of arterial instead of venous adrenaline is essential for the demonstration of the associations presented.
Small Intestinal Absorption of Glycine and Glycyl‐Glycine in Patients with Chronic Renal Failure
Authors: Sterner G. , Lindberg T. , Denneberg T.
Published: August 2010

ABSTRACT Intestinal absorption of glycine and glycyl‐glycine was studied in 9 patients with chronic renal insufficiency (mean creatinine clearance 9 ml/min) and 7 healthy controls. After an oral load of the amino acid or dipeptide, plasma α‐amino nitrogen (α‐NH2N) was measured repeatedly for two hours and the area under curve (AUC) was calculated using the trapezoidal rule. In uremic patients, plasma α‐NH2N was significantly lower after glycine than after glycyl‐glycine at 30, 45 and 60 min and also AUC was smaller after the amino acid indicating a reduced total uptake. One patient with severe, terminal uremia had a flat curve after glycine administration. In control subjects, plasma levels were lower after glycine than after glycyl‐glycine at 30 min but AUC did not differ between the amino acid and the dipeptide. Generally these results agree with those in earlier studies of non‐uremic man showing that, in small intestine, dipeptides are taken up better and by a different mechanism than amino acids.
Changes in Blood Glucose and Insulin Secretion in Patients with Senile Dementia of Alzheimer Type
Authors: Bucht Gösta , Adolfsson Rolf , Lithner Folke , Winblad Bengt
Published: August 2010

ABSTRACT A retrospective study of 839 hospital records with various dementia diagnoses showed that 63 cases had a diagnosis of diabetes mellitus as well. None of these were found in the group of patients with senile dementia of Alzheimer type (SDAT). Oral glucose tolerance tests (OGTT) were performed in patients with SDAT, multiinfarct dementia (MID), cerebrovascular disease (CVD), hospitalized control patients (Chosp) and healthy elderly persons (Celd). Fasting blood sugar was significantly lower and the areas under the OGTT curves were significantly smaller in the SDAT group than in the CVD and the Chosp group. SDAT patients had higher insulin levels than Celd during the OGTT and on a statistically significant level 90 min after ingestion of sugar. Our findings suggest that SDAT and diabetes mellitus may not co‐exist and that patients with SDAT have decreased blood sugar concentrations and elevated serum insulin levels. It is discussed whether this is an effect of the transmitter deficiencies in SDAT or may serve to explain these deficiencies.
Home Monitoring of Blood Glucose and Insulin Therapy without a Photometer
Authors: Fahlén Martin , Lapidus Leif , StrÖmblad Gunnar , Stuart‐Beck Rex
Published: August 2010

ABSTRACT. The BM‐Test‐Glycemie 1–44 test strip facilitates self‐monitoring without the use of a photometer. In a population of 33 diabetic patients (age 24.8±2.9 years) 94% took part in home monitoring for 6–10 months. Of 29 who answered a questionnaire 25 preferred blood glucose testing to urine testing. In a “beta‐cell school” it was taught that it is rational if home monitoring of blood glucose is combined with a tailored insulin treatment consisting of long‐acting insulin (Ultralente) as a basal insulin and regular insulin (Actrapid) as a meal insulin. In a group of 24 labile diabetic patients 17 preferred this regime compared to earlier use of intermediate acting insulin and regular insulin. Six of these preferred the regular insulin to be taken in three doses. Hypoglycemia, when it occurred, was less distressing in symptoms than previously. Among patients with recent onset of diabetes active participation with dose reduction was seen during the honey‐moon stage. The regime is logical and generative, offers a basis for an individualized therapy and a high remission frequency may be expected.
Methodological Aspects on C‐peptide Measurements
Authors: Ludvigsson Johnny
Published: August 2010

ABSTRACT. It is rather difficult to draw conclusions from reported C‐peptide values, as the methods for determination differ, and C‐peptide may be measured in serum or in urine with the patient fasting or after stimulation. We have followed prospectively 49 children with IDDM with regular determinations of serum C‐peptide fasting and after a standardized breakfast. A subgroup of seven patients have been studied more thoroughly with 24‐hour‐profile of serum C‐peptide, C‐peptide excretion in urine, and stimulation by i.v. glucose + i.v. arginine. Our results indicate that the stimulation of the beta cells usually reaches a maximum around a blood glucose level of 10–12 mmol/l leading to a curve linear relationship between serum C‐peptide and blood glucose. Thus a simple quotient is not so useful but the degree of stimulation should be stated and actual blood glucose value noticed. Stimulation with a standardized breakfast gives roughly the same information as maximal stimulation with i.v. glucose + arginine, and little extra information is found by a 24‐hour‐profile. Urinary C‐peptide may give valuable information if it is related to the actual degree of metabolic balance. It can be of special interest in patients with very low serum C‐peptide levels.
Ultralente Based Insulin Regimens—Clinical Applications, Advantages and Disadvantages
Authors: Turner Robert C. , Phillip Mairead A. , Ward Elizabeth A.
Published: August 2010

ABSTRACT. The prolonged action of daily injections of beef ultralente insulin provides a source for the basal, steady state insulin supply which diabetics need in addition to their meal requirements. The complete distinction between basal and meal insulin requirements, provided by two or three injections of soluble insulin per day, allows simple rules to guide both the physician and patient. Thus, the required ultralente dose needs to be continued daily, irrespective of illness or missing meals, whereas the soluble insulin requirements are given according to meals. When starting ultralente insulin therapy a loading dose is required. The doses of ultralente and soluble insulin needed for different severities of diabetes and degrees of insulin resistance can be predicted. A simple regimen to cover the decreasing insulin requirements of newly presenting, ketotic juvenile‐onset diabetics has been developed. During surgical operations the continued basal insulin supply, from ultralente insulin, greatly facilitates diabetes control. Whilst many patients have improved nocturnal blood glucose control after transfer to ultralente insulin, optimal control of diabetes sometimes remains difficult in view of the pre‐breakfast plasma glucose rise and the longer action of subcutaneous soluble insulin than the physiological meal insulin response. Purified monocomponent beef ultralente insulin is antigenic, and human ultralente insulin might be advantageous.
Effect of Different Fibers on Glucose and Lipid Levels in Diabetic Subjects
Authors: Smith Ulf
Published: August 2010

ABSTRACT. The diabetic diet has traditionally been low in carbohydrate content. However, recent studies have shown that the diet may be liberalized in this respect provided that complex carbohydrates are given. When given in amounts corresponding to 50 g starch beans, in particular, raise the blood glucose levels to only a small extent and less than various other foodstuffs tested. The reason for this is, at least in part, due to the effect of the constituent fibers. Guar is another fiber of bean origin which has been shown to lower the postprandial glucose levels. Data from long‐term treatment of diabetic patients with guar are presented.
Comparative Study of Tocainide and Lidocaine in Patients Admitted for Suspected Acute Myocardial Infarction
Authors: REHNQVIST NINA , ERHARDT LEIF , ERICSSON CARL‐GORAN , OLSSON GUNNAR , SVENSSON GÖRAN , SJÖGREN ANDREAS
Published: August 2010

ABSTRACT. The antiarrhythmic effects of tocainide, administered as a bolus injection of 750 mg followed by oral therapy, and conventional Iidocaine therapy were evaluated in 40 patients admitted for suspected acute myocardial infarction (AMI) and showing high‐grade premature ventricular complexes (PVCs). The mean hourly PVC rate before therapy was 928 and its reduction was equally significant in the tocainide group, 73%, and in the Iidocaine group, 68%. The number of 5‐minute periods with multiform, paired and R/T PVCs or ventricular tachycardia was also significantly reduced, by 78% in the tocainide group and by 71 % in the Iidocaine group. Ten patients in the tocainide group reported moderate side‐effects, compared to 13 in the Iidocaine group, where the infusion had to be discontinued in 5 patients and the rate had to be reduced in 4. Tocainide, an amine analogue of Iidocaine, is considered just as effective as Iidocaine in patients with high‐grade PVCs and suspected AMI.
Effect of Furosemide on the Lipid Abnormalities in Chronic Renal Failure
Authors: PASTERNACK A. , LEINO T. , SOLAKIVI‐JAAKKOLA T. , HUTTUNEN J. K. , EHNHOLM C.
Published: August 2010

ABSTRACT. The effect of furosemide on the lipoprotein profile and the activities of postherapin plasma lipases were studied in 12 patients with chronic renal failure. The concentrations of serum total, VLDL and LDL triglycerides were significantly higher and the concentration of HDL triglyceride was significantly lower in the patients with renal failure than in healthy controls. HDL cholesterol was significantly lower in the patients than in the controls. The activity of postherapin lipoprotein lipase was significantly lower in the patients than in the controls. The introduction of furosemide induced a significant increase in the concentrations of VLDL cholesterol and VLDL triglyceride. These changes were reversed when the drug treatment was discontinued. Postherapin lipase activities were not further altered by furosemide.