Scandinavian journal of clinical and laboratory investigation
-
In patients presenting with a possible subarachnoid haemorrhage (SAH), a negative CT scan of the head does not exclude SAH and further investigations are therefore required. Cerebral angiography identifies aneurysms but does not inform on whether they have ruptured and is resource intensive. Examination of the CSF for blood cannot distinguish between an in-vivo bleed and a traumatic lumbar puncture. ⋯ The most appropriate investigation is spectrophotometry of the CSF for the haemoglobin breakdown products, oxyhaemoglobin and bilirubin. Guidelines for the performance of spectrophotometry and interpretation have been produced, modified and are reviewed here. From 5 years' data involving 2302 scans, 92% did not support the occurrence of SAH, 4% indicated the need for angiography to identify a possible aneurysm, while 4% were equivocal due to the presence of oxyhaemoglobin in sufficient concentrations to interfere with the ability to identify bilirubin reliably.
-
Scand. J. Clin. Lab. Invest. · Jan 2009
Randomized Controlled TrialEffects of aldosterone blockade on left ventricular function and clinical status during acute myocardial infarction.
Heart failure is frequently a serious complication of acute myocardial infarction (AMI). ACE inhibitors, Angiotensin II receptor blockers, beta-blockers and aldosterone receptor blockers have been shown to improve outcomes in this setting. This study aimed to determine the effect of spironolactone on the frequency of clinical heart failure, mortality, rehospitalization and left ventricular functions determined by echocardiography. ⋯ In concordance with these findings, the ejection fraction was slightly higher in Group A than in Group B, although this was not statistically significant (47% versus 44%). This trend continued during a 6-month follow-up after randomization. Our findings suggest that early administration of aldosterone blockers provides additional benefits after AMI, reducing the incidence of post-MI angina pectoris and rhythm and conduction disturbances.
-
Scand. J. Clin. Lab. Invest. · Jan 2009
Analysis of cardiovascular responses to passive head-up tilt using continuous pulse wave analysis and impedance cardiography.
To non-invasively measure central haemodynamics, arterial stiffness, cardiac function and vascular resistance, with the subject in the supine position and during head-up tilt, in order to examine the haemodynamic changes associated with alterations in the augmentation index, and to investigate repeatability and reproducibility of the measurement protocol. ⋯ Combined pulse wave analysis and impedance cardiography with the subject in the supine position and during head-up tilt is a repeatable and reproducible method for comprehensive investigation of the cardiovascular function.
-
Scand. J. Clin. Lab. Invest. · Jan 2009
Systemic and local cytokine kinetics in musculoskeletal injury: a prospective study in patients with ankylosing spondylitis.
Back surgery in patients with ankylosing spondylitis is a major trauma in individuals with tissue inflammation and joint destruction along the spine; we used surgery in these patients as a model in the study of systemic and local cytokine profiles in complicated trauma situations. ⋯ This study indicates that a major musculoskeletal trauma principally is followed by significant increases in systemic levels of IL-6 with only modest systemic reactions in TNFalpha and IL-1beta, even in patients with an inflammatory disease. However, there are in general significantly increased local levels of IL-1beta, IL-6, IL-8 and IL-10, and our conclusion is that systemic cytokine levels might not reflect local reactions.
-
Scand. J. Clin. Lab. Invest. · Jan 2009
Variability in aggregometry response before and after initiation of clopidogrel therapy.
Evaluation of clopidogrel therapy by in vitro methods has limitations which may be of clinical importance. We wanted to explore the variability in aggregometry response in aspirin sensitive patients before and after initiation of clopidogrel therapy. ⋯ Inter-individual differences in ADP aggregation were significant both before and during clopidogrel therapy, and there were significant intra-individual variations over time. Therefore, prediction of aggregometry response before or during clopidogrel therapy based on single tests may be unreliable. Inter-individual differences in healthy controls are smaller at high concentrations of ADP, and comparisons of aggregometry response should be performed with caution unless ADP concentrations are standardized.