Quarterly Journal of Medicine最新文献_第2页

Primary angiitis of the CNS diagnosed by angiography. 血管造影诊断的中枢神经系统原发性血管炎。

Quarterly Journal of Medicine Pub Date : 1994-06-01

M Abu-Shakra, M Khraishi, H Grosman, J Lewtas, A Cividino, E C Keystone

{"title":"Primary angiitis of the CNS diagnosed by angiography.","authors":"M Abu-Shakra, M Khraishi, H Grosman, J Lewtas, A Cividino, E C Keystone","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Sixteen patients (8 female, 8 male) with primary angiitis of the CNS (PACNS), were followed prospectively in a vasculitis clinic. Diagnosis was by angiography in patients without underlying disease. Median age at diagnosis was 36.5 years, and median duration of follow-up was 28 months. Onset was acute in 14 patients (88%), with 3.5 weeks (median) from onset symptoms to diagnosis. Three women developed symptoms within 3 weeks postpartum. The most frequent symptoms were severe headaches (12, 75%), stroke (6, 30%), transient ischaemic attack (TIA) (4, 28%), seizures (7, 44%), visual aberration (3, 19%), and cognitive impairment (5, 31%). Laboratory data included high ESR (2, 13%), leucocytosis (8, 80%), thrombocytosis (1, 6%), positive antinuclear antibody titre (3, 15%), and high levels of complement (5, 31%). Lumbar puncture was performed in 12 patients (75%). CSF analysis was abnormal in five patients (42%). EEG was abnormal in 5/9 patients. The major CT/MRI scan findings were cerebral haemorrhage (4, 25%), brain infarcts (5, 31%), brain atrophy (2, 13%) and non-specific lesions (2, 13%). Four patients had normal studies. All patients received corticosteroids (CS), and five were treated with oral cyclophosphamide. Two patients relapsed despite CS and cyclophosphamide therapy. All patients are alive, and at the last assessment, eight had a permanent neurological deficit, which included paresis (3, 19%), neurocognitive abnormalities (2, 13%), visual loss (2, 13%) and seizure activity (5, 31%). Our data suggest a non-progressive, non-fatal course in those PACNS patients diagnosed angiographically and treated with CS with or without cyclophosphamide.</p>","PeriodicalId":54520,"journal":{"name":"Quarterly Journal of Medicine","volume":"87 6","pages":"351-8"},"PeriodicalIF":0.0,"publicationDate":"1994-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19037454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treatment of Graves' disease with the block-replace regimen of antithyroid drugs: the effect of treatment duration and immunogenetic susceptibility on relapse. 抗甲状腺药物阻断替代方案治疗Graves病:治疗时间和免疫遗传易感性对复发的影响

Quarterly Journal of Medicine Pub Date : 1994-06-01

A P Weetman, A P Pickerill, P Watson, V K Chatterjee, O M Edwards

引用次数: 0

Primary angiitis of the CNS diagnosed by angiography. 血管造影诊断的中枢神经系统原发性血管炎。

Quarterly Journal of Medicine Pub Date : 1994-06-01 DOI: 10.1093/OXFORDJOURNALS.QJMED.A068940

M. Abu-Shakra, M. Khraishi, H. Grosman, J. Lewtas, A. Cividino, E. Keystone

{"title":"Primary angiitis of the CNS diagnosed by angiography.","authors":"M. Abu-Shakra, M. Khraishi, H. Grosman, J. Lewtas, A. Cividino, E. Keystone","doi":"10.1093/OXFORDJOURNALS.QJMED.A068940","DOIUrl":"https://doi.org/10.1093/OXFORDJOURNALS.QJMED.A068940","url":null,"abstract":"Sixteen patients (8 female, 8 male) with primary angiitis of the CNS (PACNS), were followed prospectively in a vasculitis clinic. Diagnosis was by angiography in patients without underlying disease. Median age at diagnosis was 36.5 years, and median duration of follow-up was 28 months. Onset was acute in 14 patients (88%), with 3.5 weeks (median) from onset symptoms to diagnosis. Three women developed symptoms within 3 weeks postpartum. The most frequent symptoms were severe headaches (12, 75%), stroke (6, 30%), transient ischaemic attack (TIA) (4, 28%), seizures (7, 44%), visual aberration (3, 19%), and cognitive impairment (5, 31%). Laboratory data included high ESR (2, 13%), leucocytosis (8, 80%), thrombocytosis (1, 6%), positive antinuclear antibody titre (3, 15%), and high levels of complement (5, 31%). Lumbar puncture was performed in 12 patients (75%). CSF analysis was abnormal in five patients (42%). EEG was abnormal in 5/9 patients. The major CT/MRI scan findings were cerebral haemorrhage (4, 25%), brain infarcts (5, 31%), brain atrophy (2, 13%) and non-specific lesions (2, 13%). Four patients had normal studies. All patients received corticosteroids (CS), and five were treated with oral cyclophosphamide. Two patients relapsed despite CS and cyclophosphamide therapy. All patients are alive, and at the last assessment, eight had a permanent neurological deficit, which included paresis (3, 19%), neurocognitive abnormalities (2, 13%), visual loss (2, 13%) and seizure activity (5, 31%). Our data suggest a non-progressive, non-fatal course in those PACNS patients diagnosed angiographically and treated with CS with or without cyclophosphamide.","PeriodicalId":54520,"journal":{"name":"Quarterly Journal of Medicine","volume":"87 6 1","pages":"351-8"},"PeriodicalIF":0.0,"publicationDate":"1994-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/OXFORDJOURNALS.QJMED.A068940","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61293674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 31

Recent advances in atopic dermatitis. 特应性皮炎的最新进展。

Quarterly Journal of Medicine Pub Date : 1994-06-01 DOI: 10.1093/OXFORDJOURNALS.QJMED.A068936

J. Hunter, R. Herd

引用次数: 35

Hyperparathyroidism, glucose tolerance and platelet intracellular free calcium in chronic renal failure. 慢性肾衰竭的甲状旁腺功能亢进、糖耐量和血小板胞内游离钙。

Quarterly Journal of Medicine Pub Date : 1994-06-01 DOI: 10.1093/OXFORDJOURNALS.QJMED.A068941

Kuo-Cheg Lu, S. Shieh, Shih-Hua Lin, S. Chyr, Yaoh-Shiang Lin, L. Diang, Bi-Lian Li, W. Sheu, Y-A Ding

{"title":"Hyperparathyroidism, glucose tolerance and platelet intracellular free calcium in chronic renal failure.","authors":"Kuo-Cheg Lu, S. Shieh, Shih-Hua Lin, S. Chyr, Yaoh-Shiang Lin, L. Diang, Bi-Lian Li, W. Sheu, Y-A Ding","doi":"10.1093/OXFORDJOURNALS.QJMED.A068941","DOIUrl":"https://doi.org/10.1093/OXFORDJOURNALS.QJMED.A068941","url":null,"abstract":"Disturbance in the vitamin D/parathyroid hormone (PTH) axis may be important in the pathogenesis of glucose intolerance and insulin resistance in uraemia. To investigate possible relationships between hyperparathyroidism, intracellular free calcium ([Ca2+]i), and glucose tolerance in chronic renal failure, we measured serum intact PTH (I-PTH) by two-site immunometric assay, platelet [Ca2+]i using the fluorescent indicator fura-2, and plasma glucose and insulin after 14 h overnight fast and at 30, 60 and 120 min following a 75 g oral glucose load, in 18 chronic haemodialysis patients with elevated serum I-PTH. Calcitriol (1 microgram) was administered parenterally at the end of each dialysis session for four weeks. This significantly decreased serum I-PTH (p < 0.001) and platelet [Ca2+]i (p < 0.01). Uraemic patients initially showed marked glucose intolerance, with increased area below the glucose curve compared to healthy controls, but after 4 weeks of calcitriol treatment, this effect was significantly decreased, and there was a significant rise in the area under the insulin curve after glucose load. The insulinogenic index also increased significantly after calcitriol treatment. These data suggest that calcitriol treatment of haemodialysis patient with secondary hyperparathyroidism is associated with increased insulin secretion in response to glucose challenge, and that this change is linked to the decrease in intracellular free calcium.","PeriodicalId":54520,"journal":{"name":"Quarterly Journal of Medicine","volume":"87 6 1","pages":"359-65"},"PeriodicalIF":0.0,"publicationDate":"1994-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/OXFORDJOURNALS.QJMED.A068941","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61293854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 16

Humidity regulation in the management of asthma patients sensitized to house dust mites. 湿度调节在室内尘螨致敏哮喘患者管理中的应用。

Quarterly Journal of Medicine Pub Date : 1994-06-01

S J Hyndman, D L Brown, P W Ewan, T W Higenbottam, J W Maunder, D R Williams

引用次数: 0

Cryptococcal meningitis (C. neoformans var. gattii) leading to blindness in previously healthy Melanesian adults in Papua New Guinea. 在巴布亚新几内亚，隐球菌性脑膜炎(新生隐球菌变种加蒂)导致先前健康的美拉尼西亚成年人失明。

Quarterly Journal of Medicine Pub Date : 1994-06-01 DOI: 10.1093/OXFORDJOURNALS.QJMED.A068939

D. Lalloo, D. Fisher, S. Naraqi, I. Laurenson, P. Temu, Sinha Ak, A. Saweri, B. Mavo

引用次数: 57

Glomerular disease as a cause of isolated microscopic haematuria. 肾小球疾病是引起孤立的显微镜下血尿的原因。

Quarterly Journal of Medicine Pub Date : 1994-06-01 DOI: 10.1093/OXFORDJOURNALS.QJMED.A068937

P. Topham, S. Harper, P. Furness, K. Harris, J. Walls, J. Feehally

{"title":"Glomerular disease as a cause of isolated microscopic haematuria.","authors":"P. Topham, S. Harper, P. Furness, K. Harris, J. Walls, J. Feehally","doi":"10.1093/OXFORDJOURNALS.QJMED.A068937","DOIUrl":"https://doi.org/10.1093/OXFORDJOURNALS.QJMED.A068937","url":null,"abstract":"Microscopic haematuria is a common clinical finding, with reported prevalences of up to 22%. The role of renal biopsy in the investigation of this condition is still debated. Currently urological investigation including cystourethroscopy is often regarded as adequate. We investigated 165 patients (94 male, 71 female; mean age 37.5 years, range 10-71) referred with isolated microscopic haematuria, using renal biopsy and cystourethroscopy. All patients were normotensive with normal serum creatinine, no proteinuria, sterile urine and a normal IVU. Renal biopsy abnormalities were found in 77/165 (46.6%): IgA nephropathy (49), global or segmental mesangial proliferative glomerulonephritis without IgA deposits (16), thin membrane nephropathy (7), vascular changes suggestive of hypertension (3), interstitial nephritis (1), and membranous nephropathy (1). Only five abnormalities were found on cystourethroscopy (cystitis 3, urethral stricture 1, bladder stone 1). Two patients with cystitis also had IgA nephropathy. Biopsy abnormalities were commonest under the age of 20 (69.2%), but 40% of biopsies were abnormal even in the seventh decade of life. Because renal biopsy abnormalities are very frequent in patients with isolated haematuria, renal biopsy is indicated in patients over 45 years of age if renal imaging and cystoscopy are normal. In those under 45 years, renal biopsy should replace cystoscopy as the investigation to follow normal renal imaging.","PeriodicalId":54520,"journal":{"name":"Quarterly Journal of Medicine","volume":"87 6 1","pages":"329-35"},"PeriodicalIF":0.0,"publicationDate":"1994-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/OXFORDJOURNALS.QJMED.A068937","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61293933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 78

Hyperventilation and the chronic fatigue syndrome. 过度换气和慢性疲劳综合症。

Quarterly Journal of Medicine Pub Date : 1994-06-01 DOI: 10.1093/OXFORDJOURNALS.QJMED.A068943

S. Rosen

引用次数: 2

Recent advances in atopic dermatitis. 特应性皮炎的最新进展。

Quarterly Journal of Medicine Pub Date : 1994-06-01

J A Hunter, R M Herd

引用次数: 0