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Biomedical subjects

A Olukoga

Publications and source records attributed to A Olukoga.

8 recordsLinked to original sources
PubMed2001

An overview of biochemical markers in acute coronary syndromes.

The cardiac troponins (cTns), cTnT and cTnI, are currently regarded as being the most useful diagnostic and prognostic biochemical markers of myocardial damage in patients with suspected acute coronary syndromes (ACSs). In spite of the evidence-based nature of this observation, the uptake of serum cTn measurement in routine clinical practice--in both the UK and elsewhere, is patchy, indeed, there still exists wide variability in the range of testing and sampling strategies involving usage of the many existing cardiac markers. For evaluating suspected acute myocardial infarction (AMI) and other ACSs, international opinion favours either serum cTnT or cTnI (measured 12-24 h after admission to the emergency room)--together with a short-time window marker such as serum creatine kinase (CK) (measured on admission and perhaps again within the 12-24 h window). Translation of this strategy into universal clinical practice would require not only formulation of, but also strict adherence to, agreed clinical decision-making protocols which, in turn, would need to be backed by adequate funding.

Angina Pectoris↗
PubMed2000

Liquorice and its health implications.

This article presents an overview of the health implications of liquorice. Liquorice has beneficial applications in the medicinal and the confectionery sectors; the substance, therefore, is both widely available and commercially attractive. However, the ingestion of liquorice, and/or its active metabolites, can sometimes produce an acquired form of apparent mineralocorticoid excess (AME) syndrome, expressed as sodium retention, potassium loss and suppression of the renin-angiotensin-aldosterone system, in addition to clinical consequences such as raised blood pressure and oedema. Moreover, these metabolic changes, the mechanisms underlying which are highlighted in the accompanying text, are associated with a number of additional clinical symptoms. Considering the easy availability of liquorice itself and also of other products containing its active metabolites, it is quite possible that the health burden of liquorice-induced morbidity could be substantial. Healthcare practitioners need to be fully aware of the risks in view of a large number of reports in the literature concerning its toxicity.

Anti-Ulcer Agents↗
PubMed1999

Hypophosphataemia in general practice patients.

We compared plasma phosphate concentrations in general practice patients and hospital inpatients and outpatients over an 8-month period. The distribution of results in all three groups was similar and 12-16% of results were at or below 0.8 mmol/L. In general practice patients, 8.3% of results from males and 12.1% from females were below the lower limit of their respective reference ranges. Eighteen of these patients (0.2% of results) had plasma phosphate concentrations < or = 0.4 mmol/L. On follow-up, only two of these patients had any attributable cause for their severe hypophosphataemia; in the remainder, it was unexpected and unexplained. Hypophosphataemia in outpatients and general practice patients is more common than has previously been appreciated. We present a strategy for further investigation of these patients.

Adult↗
PubMed1999

Lessons to be learned: a case study approach: severe hyponatraemia induced by primary hypothyroidism and associated with possible increased hepatic sensitivity to thyroxine replacement.

The case is presented of a 74 year-old woman who was admitted with severe hypo-osmolar hyponatraemia associated with inappropriately raised urinary osmolality, and who was subsequently discovered to have primary hypothyroidism. A normal serum sodium concentration was restored by means of judicious fluid restriction and thyroid hormone replacement. Low dose thyroxine therapy led to rapid but modest increases in the serum activities of alanine aminotransferase (ALT) and alkaline phosphatase (ALP); both returned to normal over a period of three weeks. These sub-clinical enzyme changes may indicate tissue 'hyperthyroidism'; and in this case, the fact that they occurred acutely at only low doses of thyroxine possibly suggests an increased hepatic sensitivity to the hormone.

Aged↗
PubMed1998

Lessons to be learned: a case study approach. Primary hyperparathyroidism simulating an acute severe polyneuritis.

The case is presented of a 65 year old lady with recent onset of neuromuscular manifestations, comprising paraparesis, areflexia and unsteady gait, along with episodes of slurring of speech and diplopia, later confirmed to be due to severe hypercalcaemia--which itself was caused by primary hyperparathyroidism. Restoration of normocalcaemia, by means of rehydration and bisphosphonate therapy, resulted in clinical improvement--whilst subsequent parathyroidectomy was followed by complete resolution of all symptoms. In order to make prompt differentiation between the neurological sequelae of hyperparathyroidism and a primary neurological disorder, a high index of suspicion is required. An urgent serum calcium assay, as part of a bone profile, is mandatory in patients who present with neurological symptoms--especially the elderly, amongst whom hyperparathyroidism is especially common.

Acute Disease↗