Acta medica Scandinavica
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Acta medica Scandinavica · Jan 1983
Blood glucose and diabetes mellitus in subjects aged 85 years or more.
Blood and urine glucose values and the prevalence of diabetes mellitus were determined in the course of a health survey covering inhabitants of Tampere, Finland, aged 85 or over. Out of the total cohort, 561 (83%) subjects, of whom 82% were women, were examined. ⋯ Five per cent of the total series were on drug treatment for their diabetes; 5% of the diabetics were on insulin therapy and 25% took oral antidiabetic drugs, while 70% were either on diet or had no treatment. Diabetes seems to be common among the very aged, but it is generally mild and easy to treat.
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Acta medica Scandinavica · Jan 1983
Case ReportsLingual infarction and sudden blindness due to giant cell arteritis.
A 72-year-old woman suffered from giant cell arteritis (GCA) which developed into lingual infarction and monocular blindness. Temporary obscuration of vision and lingual symptoms such as increasing malaise, pain and intermittent claudication may precede the catastrophic results of arteritis. Emphasis is laid on early recognition and treatment of GCA.
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Acta medica Scandinavica · Jan 1982
Anion and osmolal gaps in the diagnosis of methanol and ethylene glycol poisoning.
The diagnostic value of determination of the anion and osmolal gaps was studied in 6 patients poisoned with methanol and in 5 poisoned with ethylene glycol. Increased osmolal gap was present on admission in all patients, whereas increased anion gap was present in all except one. ⋯ In the absence of alcoholic acidosis or diabetic coma the finding of a simultaneous increase in both the anion and osmolal gaps indicates methanol or ethylene glycol poisoning. Thus determinations of the anion and osmolal gaps are mandatory whenever facing metabolic acidosis of unknown etiology.
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Acta medica Scandinavica · Jan 1982
Case ReportsNeurogenic pulmonary oedema. A review of the pathophysiology with clinical and therapeutic implications.
Five cases of neurogenic pulmonary oedema (NPE) are described. The causes were mechanical trauma to the skull, subarachnoid haemorrhage and epileptic seizure. In every case a frank pulmonary oedema was diagnosed that resolved within a few days. ⋯ NPE results from a predominant alpha-receptor stimulation with massive increase in pre- and afterload. The major therapeutic efforts should be directed towards the underlying cause and, in addition, mechanical ventilation with passive hyperventilation is vital. High positive end-expiratory pressure should not be used without strict monitoring of ICP.
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Acta medica Scandinavica · Jan 1981
Comparative StudyEffect of peroral thiamine treatment on thiamine contents and transketolase activity of red blood cells in alcoholic patients.
The thiamine contents, transketolase activity and "thiamine diphosphate effect" (TDP effect) of the transketolase activity were measured in the blood of alcoholic patients during withdrawal, before and after thiamine administration (50 mg) for 10 days. The results were compared with those of healthy volunteers. The alcoholic patients showed significantly lower thiamine contents, lower transketolase activity and higher TDP effect in the blood than the healthy volunteers. ⋯ When thiamine was administered in a dose of 50 mg for 10 days, the TDP effect normalized. The transketolase activity and thiamine contents, however, were only slightly increased, probably due to the fact that the apo-enzyme content and the thiamine-binding capacity were lower in the blood of the alcoholics. Thus the TDP effect seems to reflect the relative biochemical deficiency while transketolase activity and thiamine contents seem to be dependent on the amount of apo-enzyme and on the thiamine-binding capacity as well as the degree of thiamine deficiency.