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Udgivelsesdato: 1982-Jun-7

Udgivelsesdato: 1987-Jul-6

On the basis of a review of 20 investigations (3,587 patients), the prevalence of significant ST-segment-depression (ST-depr) in patients performing an exercise test 9-30 days after acute myocardial infarction (AMI) was found to be 33% (3-70%). The reason for the considerable variation is due to a combination of several factors: 1) different and frequently incomplete definition of significant ST-depr; 2) heterogenically composed patient groups (first vs subsequent AMI, different prevalence of infarct types and localization, consecutive vs selected patients, +/- cardioactive drugs during the exercise test); 3) different procedures for the exercise tests (submaximal vs maximal; few vs several ECG leads). The great variation in the prevalence of ST-depr, is also reflected in the prognostic significance. In about half of the investigations ST-depr has been prognostic for future death and/or cardiac events while ECG changes as an isolated variable did not prove to be of prognostic significance in the remainder. In general, it may be stated that a maximal exercise test with several ECG leads is more sensitive while ST-depr at a submaximal work capacity appears to be more specific for subsequent cardiac events. Udgivelsesdato: 1989-Oct-30

Udgivelsesdato: 1982-Aug-9

Udgivelsesdato: 1986-Jun-30

Based on a semistructured questionnaire the consequences of pacemaker treatment on leisure activities in 81 patients aged 20 to 60 years were investigated. At follow up after an average of 33.8 months, 36 of the 72 survivors participated in the following out-of-the-home physical activities: Badminton (3), bicycle-riding (6), firefighting (1), fishing (3), golf (2), gymnastics (3), handball (1), hunting (4), riding (1), running/jogging (4), sailing (5), shooting (2), skiing (3), soccer (5), swimming (1), theatre (1), chorus (1), and tennis (2). No significant changes in the levels of activity before and after pacemaker implantation were observed. Twenty of the patients did not feel the pacemaker had affected their levels of physical activity while ten patients experienced improvement in their physical capacities. Six patients felt that the pleasure in performing their favourite sport was restricted mainly due to fear of damaging the battery. Fifteen patients (21%) were members of sport clubs. These results imply that several leisure activities are available for pacemaker patients. In case a particular sport is of interest, this should be taken into account when the sitting of the pacemaker battery is decided. Udgivelsesdato: 1989-Oct-16

Udgivelsesdato: 1981-Aug-3

Udgivelsesdato: 1987-Dec-21

Udgivelsesdato: 1985-null Recurrent petechiae of the lower legs and signs of asymptomatic primary biliary cirrhosis have been found in three women. Large immune complexes were identified in the serum of three and cryoglobulin/cryofibrinogen in two. Histological examination of skin biopsies revealed a leukocytoclastic vasculitis in all three patients. Direct immunofluorescent studies showed deposits of IgM, C3 and fibrinogen in and around the walls of the small vessels of the skin of two and C3 as well as fibrinogen in one patient. It is suggested that leukocytoclastic vasculitis may be a microscopic feature of the systemic involvement in asymptomatic primary biliary cirrhosis, and petechiae the clinical manifestation.

Udgivelsesdato: 1988-Apr-18

Udgivelsesdato: 1988-Aug-15

Udgivelsesdato: 1985-Aug The possible pathogenetic significance of platelet-associated immunoglobulin G in systemic lupus erythematosus (SLE) has been studied, using a semiquantitative immunofluorescence technique. The study included 22 patients suffering from SLE during the period 1973-81. Thirteen patients had various clinical and/or laboratory signs of disease activity at the time of investigation, but none showed thrombocyte values below the normal range. A positive reaction for platelet-associated immunoglobulin in serum (indirect PlIgG) was demonstrated in 73 percent of the cases and in two patients on their own platelets also (direct PlIgG). The study included investigation of ANA (80% positive) and anti-DNA (positive in three patients only). A significant negative correlation was found between indirect PlIgG and platelet count and between ANA (/IgG or IgM) and platelet count. Indirect PlIgG correlated with known expressions of disease activity, as high ESR and low Hb, and in patients with direct PlIgG, several markers of disease activity were found to be present. It is concluded that PlIgG may be of pathogenetic importance and can be used as a marker of disease activity.

Udgivelsesdato: 1984-Dec-10

Udgivelsesdato: 1983-Jun-6

Introduction: Troponin elevations occur in a myriad of clinical conditions other than myocardial infarction (MI) and imply a poor prognosis. So far, data comparing the short-term outcome in patients with myocardial injury vs. patients with type 1 or type 2 MI are not available Methods: Over a 1-year period we prospectively studied hospitalized patients having cardiac troponin I (cTnI) measured on clinical indication. The diagnosis of type 1 and type 2 MI was according to the universal definition involving a rising and/or falling pattern of cTnI values above the decision limit of 30 ng/L. cTnI elevations above this limit in patients without overt myocardial ischemia were defined as myocardial injury. A 1-month follow-up was done with mortality as endpoint Results: The study covered 1577 consecutive patients with cTnI values >30 ng/L, of whom 360 had a type 1 MI, 119 a type 2 MI and 1089 had myocardial injury. Type 1 MI patients were younger with a median age of 70 (IQR 61-81) yrs, whereas the median ages in type 2 MI and myocardial injury were higher but comparable : 78 (IQR 67-84) vs. 77 (IQR 67-85) yrs. Peak cTnI values, however, were highest in type 1 MI: 3820 (530-19030) ng/L, lower in type 2 MI: 850 (390-3270) ng/L, and smallest in patients with myocardial injury: 90 (50-270) ng/L (p=0.0001). At one-month follow-up 285 patients had died. Mortality in the different subgroups was: 9% (33/360) in type 1 MI, 24% (28/119) in type 2 MI, and 21% (224/1089) in patients with myocardial injury. The results are depicted in the figure (Kaplan-Meier curves, log-rank-test; p-value

Udgivelsesdato: 1984-May-21