Acta medica Scandinavica
-
Acta medica Scandinavica · Jan 1981
Oxypurine release in cardiac disease. An indicator of general hypoxia in patients with cardiac arrest.
The excretion of hypoxanthine-xanthine and uric acid in urine and the concentrations in peripheral venous blood were determined in nine patients with cardiac arrest due to acute myocardial infarction (AMI), in ten control patients with AMI without cardiac arrest and in nine with angina pectoris. The patients with cardiac arrest showed a 6-fold increase in urinary excretion of hypoxanthine-xanthine 0-2 hours after cardiac arrest. ⋯ The urinary excretion of hypoxanthine-xanthine increases considerably in connection with reversible cardiac arrest, indicating general tissue hypoxia. No relationship could be found between the duration of cardiac arrest and the increased hypoxanthine-xanthine excretion in the urine.
-
Acta medica Scandinavica · Jan 1981
Case ReportsHereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease) complicated by pulmonary arteriovenous fistula and brain abscess.
A man who developed two brain abscesses was later found to have hereditary hemorrhagic telangiectasia with a pulmonary arteriovenous fistula. Brain abscess is a known complication of pulmonary arteriovenous fistulas. About 15% of patients with hereditary hemorrhagic telangiectasia develop such a fistula during their lives. Surgical resection of pulmonary arteriovenous fistulas is recommended because of the risk of severe neurological sequelae.
-
Acta medica Scandinavica · Jan 1980
Hemoperfusion with Amberlite resin in the treatment of self-poisoning.
Ten patients with various intoxications were treated with resin hemoperfusion. Three of four patients with grade IV coma due to tricyclic antidepressant (TCA) poisoning could be extubated during or on termination of hemoperfusion. Clearance values of 135--185 and 190--200 ml/min were obtained for amitriptyline and nortriptyline, respectively. ⋯ Four patients with mushroom poisoning were treated with combined hemoperfusion-hemodialysis. A transient fall in platelet count was seen in all patients. Resin hemoperfusion is of definite value in selected, severe cases of self-poisoning with psychotropic drugs such as TCA and possibly in cases of mushroom poisoning where the prognosis with hemodialysis and supportive therapy is doubtful.
-
In the population study "70-year-old people in Göteborg" 45.5% of the probands were found to have an increased exertional dyspnea or to be short of breath at the medical examination. We have found it interesting to estimate to what extent a subjective experience of dyspnea at the age of 70 is related to disease and whether it is available for treatment. Out of these probands, 64% of the males and 48% of the females suffered from cardiac failure or pulmonary disease, compared to 48% of males, and 24% of females without dyspnea. ⋯ They also had a significantly lower peak flow rate. A dyspnea that was not statistically related to disease was found in 30% of the males and 43% of the females. During a 5-year follow-up there was no statistically significant difference in mortality between dyspnoic probands without cardiopulmonary disease and others.
-
Acta medica Scandinavica · Jan 1980
Case ReportsStokes-Adams attacks requiring pacemaker treatment in three patients with acute nonspecific myocarditis.
Three patients, aged 16--44 years, with complete heart block in acute myocarditis are reported. The diagnosis of myocarditis was based on the development of transitory repolarization disturbances on the ECG in association with clinical signs of acute infectious disease. ⋯ The patients were all successfully treated with temporary intracardiac pacing but one of them later turned out to require a permanent pacemaker. The possibility of differences in localization and in prognostic importance of conduction disturbances between infectious and ischemic myocardial disease is discussed.