Annals of clinical research
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The accuracy of primary diagnosis made by general practitioners and paediatric house officers was assessed from a nationwide series of 130 Finnish children with bacterial meningitis. Meningitis was diagnosed at the first medical examination in 76 (58%) of the cases (32/70, 46% at physician's office versus 44/60 (73%) in hospital emergency rooms; p less than 0.005). In 44 cases (34%), there was a time lapse (mean, 1.7 days) between the first examination and the diagnosis of bacterial meningitis. ⋯ The overall mortality rate was 5/130 (4%) and the frequency of neurological sequelae was 28/130 (22%). The existence of potentially avoidable diagnostic delay in childhood bacterial meningitis was confirmed. Means of avoiding such potentially disastrous delay were discussed briefly.
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In order to determine the fluidity of erythrocyte membrane ghosts the degree of random orientation of excited diphenylhexatriene molecules (anisotropy) was examined in normal and diabetic juveniles. A small but significant enhancement of diphenylhexatriene anisotropy was observed in diabetic erythrocyte membranes when compared with control (0.184 +/- 0.013 versus 0.152 +/- 0.010). ⋯ Linear relationships were seen between glycosylated hemoglobin and glycosylated membrane proteins (r = 0.767) as well as between glycosylated haemoglobin and membrane anisotropy (r = 0.741). We suggest that membrane protein glycosylation enhancement occurring in diabetes could be one of the reasons of the lowered diabetic erythrocyte membrane fluidity.
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Using the formulae of Fazio and coworkers, the regional extravascular lung water per blood volume and flow was calculated in normal volunteers, in patients with left heart failure, sarcoidosis, allergic alveolitis and pneumonia. The double-isotope technique was used. 113mIn-chloride was intravascular tracer and 123I-antipyrine extravascular tracer. They were injected intravenously as rapid bolus. ⋯ The cardiac group was also divided into three subgroups after radiological grading of pulmonary venous hypertension. Between GR I (n = 17) without signs of venous hypertension and GR II (n = 18) with signs of venous congestion no significant differences in regional extravascular lung water were found. However, in GR I and GR II the values for regional extravascular water increased when compared to the control group, which is probably due to increased perfusion of vessels or increased blood volume in these cardiac patients.(ABSTRACT TRUNCATED AT 400 WORDS)
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Randomized Controlled Trial Clinical Trial
Lorcainide in the prophylaxis of ventricular arrhythmias in acute myocardial infarction.
Lorcainide, a new class I antiarrhythmic agent, was administered intravenously to eight patients with acute myocardial infarction for 24 hours, and thereafter given by mouth, 200 mg daily for ten days. Ten control infarction patients were given lidocaine 3 mg/min during the first 24 hours and the oral betablocking agent, pindolol, for the following ten days. The two groups were comparable with respect to age, sex, onset-admission interval, and site and size of infarction. ⋯ No major adverse effects were noticed, mild insomnia being the most disturbing reaction. It is concluded that lorcainide is an acceptable alternative to lidocaine in the treatment of ventricular arrhythmias in the acute stage of myocardial infarction. It has the advantage of being effective by oral route, too.
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Twenty young male athletes, aged 14 to 16 years, and 20 nonathletic male controls of the same ages were studied with regard to atrioventricular block using ambulatory ECG recording. Among the athletic youngsters, the mean hourly heart rates were significantly (p less than 0.01) lower during most of the night hours and during school hours when activities in both groups were uniform. ⋯ Among the nonathletes, first degree block was found in one case and second degree Wenckebach-type block in another. The results indicate that after approximately 3 years of physical training, on average 5 times a week, various forms of atrioventricular block, apparently vagally mediated, are observable in young athletes more often than in nonathlete controls.