Annals of clinical research最新文献

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.

Membrane ion transports were investigated in lymphocytes from young normotensive and borderline hypertensive offspring with and without heredity for hypertension. Borderline hypertension per se was associated with an enhancement of sodium-potassium pump activity. Heredity per se was associated with increased sodium influx and ouabain-resistant sodium efflux.

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 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.

To determine the factors associated with deaths from asthma we surveyed retrospectively all the death certificates issued in two regions of Finland (the province of Oulu and the province of Turku and Pori) over a ten-year period in which asthma had been given as the main cause of death. We then examined patients' records to check whether asthma was the main cause of death. A total of 156 deaths could be ascribed to asthma, 87 in patients under 65 at death and 69 over 65. More deaths tended to occur during the weekends, and in the younger age group more occurred during the night than by day. Previous drug treatment was considered inadequate in 45% of the cases. The management and drug treatment of the final exacerbation phase were also often inadequate, at least among the younger victims, and the terminal attack was usually short, death often occurring in three hours or less. Despite the shortcomings in treatment, the number of deaths from asthma in the younger age group has fallen in the province of Oulu over the last 20 years.

An elderly man with small cell lung cancer developed a largely reversible, dementia-like syndrome after cranial irradiation and prolonged treatment with interferon (IFN). The development of the symptoms started 2 months after cranial irradiation following more than 2 years of IFN treatment. The behavioral impairment did not suggest any specific brain localization. The dementia-like behaviour may be due to a combined effect of irradiation and IFN.

Digitised M-mode echocardiography was used to study the diastolic left ventricular function in ten patients with constrictive pericarditis. Each patient was matched for heart rate and stroke volume with a control patient who had normal left ventricular end-diastolic pressure and coronary arteries. All 20 patients underwent right and left cardiac catheterisation. In patients with constrictive pericarditis compared with controls, the median (range) left ventricular peak diameter lengthening rate, normalised for end-diastolic dimension, was 4.5 (2.5-8.0) s-1 and 2.9 (1.6-4.1) (p less than 0.01), and the rapid filling period fraction of diastole was 0.28 (0.18-0.37) and 0.37 (0.21-0.58) (p less than 0.05), while the mitral valve E-F slope was 20.1 (10.5-39.2) cm/s and 11.8 (7.6-14.5) (p less than 0.05), respectively. Thus, the early rate of left ventricular diameter lengthening is increased in constrictive pericarditis independent of heart rate and stroke volume, while the actual duration of the rapid filling period is decreased. These results, obtained noninvasively, extend the findings of previous invasive studies. The method may help in the difficult clinical diagnosis of constrictive pericarditis, although there is some overlap with the normal control range.

For over a hundred years Finnish sauna has been documented as a physiotherapeutic method in respiratory diseases. Physiological changes of ventilation remain small (about 10%) in the sauna. Heat load, sauna air and sympathetic stimulation generally do not cause problems to the lungs. Electron microscopic studies have not shown irreversible damages to the airway epithelium. Sauna takers should avoid bathing during acute respiratory infections. Sympathomimetic drugs may provoke tachycardia and arrhythmias in the sauna.