COLE, W., G.;JAENISCH,, R.;BATEMAN, J., F.
doi: 10.1093/oxfordjournals.qjmed.a068297pmid: N/A
Article PDF first page preview Close This content is only available as a PDF. © Oxford University Press
doi: 10.1093/oxfordjournals.qjmed.a068300pmid: N/A
Article PDF first page preview Close This content is only available as a PDF. © Oxford University Press
BARER, D., H.;MITCHELL, J. R., A.
doi: 10.1093/oxfordjournals.qjmed.a068298pmid: N/A
Abstract Data collected by a single observer on 362 patients taking part in an acute intervention trial were used to derive simple methods of predicting outcome in conscious stroke victims. The effectiveness of these univariate methods was then compared with that of multivariate models based on discriminant function analysis. The multivariate models were somewhat better at predicting death within the first month in newly-admitted patients, and in predicting lack of functional improvement between one and six months in those still in hospital at one month. Even so, these predictions could not be made with certainty and the improvements in probability offered by multivariate over univariate analysis are unlikely to be of practical benefit to the clinician. Single variables such as power in the affected arm and continence were as good as the discriminant functions at predicting discharge within the first month and first six months, respectively. The predictive power of these single simple clinical vaiables was validated in a separate group of 277 stroke patients. The various proposed methods of prognostication in stroke need to be compared in prospective studies, but until this is done, we recommend a simple approach using the best available clinical information. This content is only available as a PDF. Author notes *Present address: Senior Registrar, Department of Health Care of the Elderly, c/o Stroke Research Unit, General Hospital, Nottingham NG1 6HA. © Oxford University Press
doi: 10.1093/oxfordjournals.qjmed.a068299pmid: N/A
Abstract Five hundred and thirty-three patients in the Oxford renal unit were reviewed to determine the incidence of infection in one calender year. There were 310 patients who received dialysis, 53 with acute renal failure and 211 with chronic renal disease. Renal transplant patients were not included in the study. Apart from infections related to dialysis access, patients on maintenance haemodialysis or continuous ambulatory peritoneal dialysis developed few serious infections unless they had another disease causing suppression of immune function. A total of 97 urinary tract infections were seen; in patients with chronic renal disease not receiving dialysis the incidence of urinary tract infection was significantly associated with increasing uraemia, with diabetes, and with treatment with azathioprine or cyclophosph amide. In patients with acute renal failure, Gram-negative septicaemia and fungal infections were important causes of morbidity and mortality, but cardiovascular disease caused 42 per cent of the deaths unlike results from other series where sepsis has been by far the commonest cause of death. This content is only available as a PDF. © Oxford University Press
doi: 10.1093/oxfordjournals.qjmed.a068301pmid: N/A
Abstract The spectrum of idiopathic hypoparathyroidism in black South Africans is described. Twelve patients were seen over a seven-year period. Major presenting features were tetany in 11, epilepsy in four, congestive cardiac failure in three, cataracts in four, neuropsychiatric disease in two, and basal ganglia calcification in four. Hypocalcaemia and hyperphosphataemia were apparent in all subjects at presentation. Parathyroid hormone levels were absent or inappropriately low in all. Important features highlighted were the long duration of symptoms before diagnosis, the suppression of tetany by treatment with diphenylhydantoin, the association of idiopathic hypoparathyroidism and epilepsy in adults, and the occurrence of reversible cardiac muscle dysfunction. This content is only available as a PDF. © Oxford University Press
MARSHALL, S., M.;ALBERTI, K. G. M., M.
doi: 10.1093/oxfordjournals.qjmed.a068302pmid: N/A
Abstract Overnight albumin excretion rates were measured in 940 diabetic patients, 416 with insulin dependent and 524 with non-insulin dependent diabetes, and in 106 healthy volunteers. A significantly higher number of noninsulin dependent diabetic patients had abnormal albumin excretion compared with the insulin-dependent group (χ2=15.2, p<0.002). Ten per cent of non-insulin-dependent and 7 per cent of insulin-dependent diabetic patients had albumin excretion rates in the range 30-150 μg/min and thus were at risk of the cardiovascular and renal complications of diabetes. Six per cent of non-insulin-dependent and 5 per cent of insulin-dependent diabetic patients had albumin excretion rates above 150 μg/min and thus were entering the phase of clinical diabetic nephropathy. Multivariate analysis revealed that male sex and retinopathy in insulin-dependent diabetes, and systolic blood pressure and retinopathy and peripheral vascular disease in non-insulin-dependent diabetes, were significantly related to albumin excretion. Only one patient with insulin-dependent diabetes were significanatly related of albumin excretion. Only one patient with insulin-dependents diabetes of less than 5 years know duration had an albumin excretion. Only one patient with insulin-dependent diabetes of less than 5 years known duration had an alburmi excretion rate in the range 30-150 μg/min, whereas such an excretion rate indicating patients at risk was observed at all duration of non-insulin-dependent diabetes. It is possible that during the long silent phase of non-insulin-dependent diabetes, before diagnosis, significant renal damage occured. This content is only available as a PDF. © Oxford University Press
MYSZOR, MARGARET, F.;RICH, A., J.;BOTTRILL,, PATRICIA;RECORD, C., O.
doi: 10.1093/oxfordjournals.qjmed.a068303pmid: N/A
Abstract During the 18 months following the introduction of a neodymiun yttrium aluminium garnet laser in Newcastle upon Tyne 48 patients were treated, 23 for haemorrhage from peptic ulcers or vascular anomalies of the gut and 25 for palliation of inoperable tumours of the oesophagus, stomach and rectum. The treatment was tolerated well and was effective both for the arrest of haemorrhage and relief of dysphagia. Laser treatment has now entered the realms of routine clinical practice but its high cost and the operator expertise required suggest that its availability should be limited to designated centres. This content is only available as a PDF. © Oxford University Press
SENAPATI,, ASHA;GILLIAN,, JENNER;THOMPSON, R. P., H.
doi: 10.1093/oxfordjournals.qjmed.a068304pmid: N/A
Abstract Zinc levels in plasma and leucocytes of elderly patients with and without cutaneous ulcers and in hospital were compared with those of a group of healthy elderly living at home and of a younger group. The groups in hospital had lower levels of plasma and leucocyte zinc than the control groups, but these were not associated with cutaneous ulcers. The zinc intake of the patients in hospital was well below the recommended daily allowance. Tissue zinc levels were found to be low in elderly patients in hospital, probably due to poor intake, but their contribution to the formation of skin ulcers was unproven. This content is only available as a PDF. © Oxford University Press
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