[It is necessary to reform health services for immigrants. Psychological and social problems are neglected].
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Biomedical subjects
Publications and source records attributed to A Forkman.
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127 patients with suspected herpes simplex encephalitis (HSE) were entered in a prospective randomised study of acyclovir 10 mg/kg 8-hourly versus vidarabine 15 mg/kg daily for 10 days. The patients were consecutive and nearly all Swedish cases of HSE were included; they were treated in six university infectious diseases departments. The diagnosis of HSE was verified by brain biopsy and/or antibody responses in serum and cerebrospinal fluid. Of 53 confirmed cases of HSE (corresponding to 2 X 3 cases per million inhabitants per year in Sweden), 51 (27 acyclovir, 24 vidarabine) were evaluable for analysis of efficacy. The mortality was 19% in the acyclovir-treated group versus 50% in the vidarabine group (p = 0.04). At 6 months of observation 15 (56%) of 27 acyclovir-treated patients had returned to normal life compared with 3 (13%) of 24 vidarabine-treated patients (p = 0.002); and the numbers who died or had severe sequelae were 9 (33%) and 19 (76%), respectively (p = 0.005). No important or new adverse events were recognised.
Serum concentrations of cholic (CCA) and chenodeoxycholic (CCDA) acid were measured by radioimmunoassay in 27 patients with acute hepatitis of various aetiologies. In the icteric phase, serum bile acids were strongly elevated, usually with a predominance of CCA. As the disease resolved, however, CCDA was the predominant bile acid in serum in most patients. Serum CCA and CCDA levels returned to normal values at approximately the same time as aminotransferases. The results indicate that determinations of serum bile acids provide no further information than conventional liver tests during the course of acute hepatitis.
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