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- Lindgren, Arne, et al.
(författare)
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Plasma homocysteine in the acute and convalescent phases after stroke
- 1995
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Ingår i: Stroke: a journal of cerebral circulation. - 1524-4628. ; 26:5, s. 795-800
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Stroke patients frequently manifest moderate hyperhomocysteinemia. In most published studies, plasma homocysteine was measured at least 1 month after stroke (or the interval was not reported). To determine whether plasma homocysteine concentrations change in the acute phase, we compared acute-phase values with both convalescent-phase and control values. METHODS: Plasma homocysteine concentrations were measured in the acute phase (mean, 2 days after stroke onset) in 162 first-ever stroke patients aged 50 years or more (median, 75 years) and again at a median interval of 583 days (range, 460 to 645 days) after stroke onset in a subgroup of 17 patients, with values for 60 age-matched subjects serving as controls. Twenty of the control subjects were reexamined 2 to 3 years after their initial examination. RESULTS: The median plasma homocysteine concentration was 13.4 mumol/L in the patient group compared with 13.8 mumol/L for control subjects (NS, Mann-Whitney U test) and increased from 11.4 mumol/L in the acute phase to 14.5 mumol/L in the convalescent phase in the subgroup of patients examined twice (P < .01, Wilcoxon signed rank test). In the 20 reexamined control subjects, no significant change over time in plasma homocysteine concentration was found. CONCLUSIONS: The post-acute-phase increase in plasma homocysteine may explain why higher values were obtained for stroke patients than for control subjects in previous studies. Possible reasons for the variation in plasma homocysteine concentrations over time are (1) an acute-phase reduction secondary to a decrease in plasma albumin and (2) an increase in plasma homocysteine during the convalescent phase due to modified vitamin intake and/or lifestyle. The timing of plasma homocysteine measurements relative to stroke onset is a factor to be considered in the interpretation of results.
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- Rylander, Christian, 1960, et al.
(författare)
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Preoperative risk assessment in vascular surgery patients
- 1999
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Ingår i: Current Anaesthesia and Critical Care. ; 10, s. 179-185
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Forskningsöversikt (refereegranskat)abstract
- The patient scheduledf or peripheral vascular surgery is an increaseda naestheticc hallenge, mainly because of coexisting generalized cardiovascular atherosclerotic involvement leading to a high risk of perioperative cardiac complications. In clinical practice it is of importance preoperatively to predict, as accurately as possible, the potential risk of complications so that proper risk-reducing measures can be taken. Relevant clinical data, which have been included by Goldman and Detsky in multifactorial cardiac risk indices, are of potential value for differentiating between patients at low, intermediate, or high risk of perioperative cardiac morbidity and mortality. Patients with low risk scores can be accepted for surgery without further testing, thereby allowing more extensive cardiac testing, such as ambulatory ECG monitoring, exercise stresst esting, echocardiography,d ipyridamole thallium imaging, or coronary angiography,t o be reserved for patients with higher risk scores or overt cardiac problems. The risk stratification is of importance not only for decisions on preoperative prophylactic therapeutic measures (e.g. optimization of medical therapies, coronary artery revascularization), but also for decisions on intraoperative anaesthetic management and postoperative care
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- Svartberg, J, et al.
(författare)
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Tumour-induced hypoglycaemia in a patient with insulin-dependent diabetes mellitus
- 1996
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 239:2, s. 181-185
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Tidskriftsartikel (refereegranskat)abstract
- We report on a case of malignant insulinoma occurring in a patient with genuine insulin-dependent diabetes mellitus (IDDM). A review of cases concerning patients with diabetes mellitus and insulinomas is presented, and reveals only patients with non-insulin-dependent diabetes mellitus (NIDDM). Our case appears to be the first in showing the combination of IDDM and a functioning malignant insulinoma.
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