Annals of clinical research最新文献

The changes in serum triglycerides, cholesterol and high density lipoprotein (HDL) cholesterol were followed in patients with pneumonia caused by different bacteria or viruses as well as in those with no defined aetiology. In the acute phase of the disease there was: 1) a fall in serum triglycerides in patients with bacteremic pneumococcal disease and in patients with no defined aetiology (p less than 0.01 and less than 0.005, respectively). 2) a reduction in cholesterol in all aetiological groups (p less than 0.001) except for those with viral pneumonias, where only 4 patients were studied, and 3) a fall in HDL cholesterol in all the groups (at least at p less than 0.05) except in those with virus infection. 4) In bacteraemic pneumococcal disease the cholesterol level (mean 2.6, SEM 0.3 mmol/l) was lower than that in the other groups (at least at p less than 0.05). In the acute phase there was a tendency to a negative correlation of erythrocyte sedimentation rate and of C-reactive protein with serum cholesterol and/or HDL cholesterol. Changes in serum lipids in various infections deserve further pathophysiological investigation.

Sauna bathing may affect the fluid, electrolyte and acid-base balance. In addition to sweating and thirst, a sauna bath also has effects on many endogenous regulatory mechanisms maintaining the balance between the fluid compartments and appropriate distribution of the circulating blood. Although the sauna-induced fluid loss is usually not very severe, its adequate replacement as early as possible is important. In practice, the most convenient and effective way is to replace the fluid loss by small liquid doses repeated frequently during the bathing. If a sauna bath is taken after heavy physical activity, the fluid compensation may be necessary already before bathing.

Serum C reactive protein was determined in 30 control subjects, 32 patients with pancreatic cancer, 28 with chronic pancreatitis and 23 with extra-pancreatic diseases of the upper gastrointestinal tract. The aim was to ascertain possible alterations of this index in chronic pancreatic disease and to speculate on some influencing factors. Higher C reactive protein levels were found in pancreatic cancer as compared to controls. Pancreatic cancer patients with systemic metastases had higher levels of this index compared to those with non-metastatic disease. Raised concentrations of C reactive protein were detected in 7/28 subjects with chronic pancreatitis. In this group these higher levels were found in patients in a relapsing phase of the disease; no association was observed with pancreatic pseudocysts. Among all subjects a correlation was found, between C reactive protein and age; patients with abnormal fasting blood glucose levels or increased white blood cell count had higher levels of this protein as compared to the remaining patients. We may conclude that C reactive protein increases in pancreatic cancer, specially in relation to tumour extent; in chronic pancreatitis it reflects the inflammatory status of the gland. While acting in the context of the acute phase response, this test may provide an adjunct in evaluating patients with a chronic pancreatic disease.

Sauna bathing is a pleasant and relaxing experience that combines psychic, physical and social pleasures. A person's inner feelings about sauna bathing, its essential components are mainly unconscious. The sauna bath reduces the aggressive behaviour and enables bathers to forget the commonplace pressures of everyday life. The sauna evokes memories of childhood development, awakening feelings of maternal warmth and paternal power in the bather. The sauna is a positive mental health resource, even though its effects are transitory.

Factors responsible for unsuitability for bypass surgery were assessed prospectively in 324 consecutive patients with serious angina pectoris undergoing cardiac catheterization. One hundred patients were found to be unsuitable for surgery (31%). These patients usually had peripheral coronary atherosclerosis (44%), stenotic/occluded artery distributing to an infarcted (35%) or small area (25%), or reduced global left ventricular (LV) function (15%). Age over 65 years (p less than 0.05), female sex (p less than 0.05), previous myocardial infarction (p less than 0.05), 1-vessel disease (p less than 0.01) and a low LV ejection fraction (p less than 0.01) occurred more often in patients not accepted for surgery. Of the patients with 3-vessel disease 75% were referred for surgery while only 25% of patients with 1-vessel disease (p less than 0.001) Stepwise logistic regression analysis identified LV ejection fraction as an inverse predictor (p less than 0.001) and number of stenotic coronary arteries as a predictor (p less than 0.001) of suitability for surgery. Thus, peripheral coronary atherosclerosis and global LV function are the main factors determining unsuitability for coronary bypass surgery.

The concentrations of whole blood and plasma selenium, plasma lipid peroxides and the glutathione peroxidase activity in plasma and erythrocytes were measured in untreated and treated children with neuro- (n = 23) and nephroblastoma (n = 32) aged 6 months to 15 years. The patients were divided into the following groups: 0.5-1, 1-3, 3.5-6 and 8-15 years old. In all the groups of cancer patients investigated selenium concentration in whole blood and plasma and glutathione peroxidase activity in erythrocytes and plasma were significantly lower than in the age-matched healthy children. The concentrations of lipid peroxides in plasma of children with cancer was higher than in the age-matched control group. No differences were observed between the levels of the determined parameters in children with neuro- and nephroblastoma. Nor were there any differences in the determined parameters between children before and during treatment with cytostatics and between children at different stages of the disease. A significant linear correlation was found between plasma selenium concentration and glutathione peroxidase activity in the erythrocytes and plasma of children with cancer.

Epidemiologic studies suggest that a high level of physical activity would protect against coronary heart disease. There is accumulating evidence that habitual physical training may reduce some risk factors of atherosclerosis in both non-diabetic and in diabetic subjects. In this article the relationship of exercise to cardiovascular risk factors in diabetic patients is reviewed.