Paracetamol interference with blood glucose analysis: a potentially fatal phenomenon.
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Biomedical subjects
Publications and source records attributed to F Moran.
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1. CM-cellulose chromatography of a fraction soluble in 5% perchloric acid from Ceratitis capitata chromatin yields three proteins, C1a1, C1a2 and C1b, which have been purified to electrophoretical homogeneity. 2. C1a1, C1a2 and C1b analyse like high mobility group (HMG) non-histone chromosomal proteins, although they do not exactly correspond with those from vertebrates. It is proposed that C1 proteins, as well as Drosophila D1 [Rodríguez Alfageme et al. (1980) Chromosoma, 78, 1-31] are representative of a class of insect-specific HMG proteins. Tryptic fingerprints show that C1a1 and C1a2 are very similar, but C1b is a somewhat distinct protein. Circular dichroism studies have shown that these preparations do not appreciably fold on increasing ionic strength. 3. The interactions between DNA and C1 proteins have been studied. These proteins precipitate DNA in 0.15 M NaCl, 0.015 M sodium citrate and the precipitation curves are cooperative. Soluble complexes between C1 proteins and DNA could be prepared in low ionic strength media and their thermal denaturation profiles obtained. C1 proteins do not destabilize DNA under the conditions used to prepare the complexes but the three proteins stabilize DNA to a different degree. From these studies it has been concluded that the association constant of C1b to DNA is smaller than that of C1a1 and C1a2.
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Data from a drug surveillance programme were analysed to estimate the frequency with which patients with a diagnosis of respiratory failure had been exposed to CNS-depressing drugs. Eleven out of 37 patients with respiratory failure had received such medication. A detailed comparison of these patients and controls admitted to hospital because of respiratory disease who did not develop respiratory failure failed to reveal significant differences in drug usage. This unexpected finding suggests that patients with respiratory disease of equal severity may vary greatly in their tendency to develop carbon dioxide retention following administration of drugs with respiratory depressant properties.
In two patients who had recently undergone major abdominal operations and were later suspected of having pulmonary emboli, pulmonary angiography showed no evidence of embolism, but in both cases one of the hemidiaphragms was clearly outlined by contrast material. It is suggested that subdiaphragmatic inflammation was responsible for this unusual appearance.
Several series have suggested that pulmonary function abnormalities are common in systemic lupus erythematosus. However, only isolated studies have attempted to relate these abnormalities to immunological aspects of the diseases. In the present study respiratory symptoms, pulmonary function tests, and immunological data were reviewed in 22 patients with systemic lupus erythematosus. Seventeen subjects had either clinical evidence or abnormalities of lung function suggestive of pulmonary involvement. A restrictive ventilatory defect or reduction in pulmonary diffusing capacity for carbon monoxide was demonstrated in 14 of the patients only 4 of whom were dyspnoeic. There was no correlation between pulmonary involvement, co-existent renal lupus, and immunological abnormality.
1. The pulmonary transfer factor for carbon monoxide was measured by the single-breath method in 21 pregnant women with no previous history of cardiac or respiratory disease. Measurements were made at monthly intervals throughout pregnancy and once post partum. 2. The transfer factor was higher in the first trimester of pregnancy than in the non-pregnant state. There was a fall in the transfer factor during pregnancy until 26 weeks gestation, after which no further decrease was observed. 3. The changes in transfer factor were not explained by alterations in haemoglobin concentration or alveolar volume. 4. Simultaneous serial estimation of plasma 17beta-oestradiol were performed in all the subjects. There was no obvious direct relation between changes in the concentration of this hormone and transfer factor measurements.
In larger pulmonary function laboratories there is a need for computerised techniques of data processing. A flexible computer system, which is used routinely, is described. The system processes data from a relatively large range of tests. Two types of output are produced--one for laboratory purposes, and one for return to the referring physician. The system adds an automatic interpretative report for each set of results. In developing the interpretative system it has been necessary to utilise a number of arbitrary definitions. The present terminology for reporting pulmonary function tests has limitations. The computer interpretation system affords the opportunity to take account of known interaction between measurements of function and different pathological states.
The 3 orthogonal lead electrocardiogram has been evaluated with computer assisted interpretation in 20 patients with acute pulmonary embolism confirmed by pulmonary angiography. Initial 3-lead electrocardiographic abnormalities were found to be at least as helpful as the 12-lead electrocardiogram in supporting the clinical diagnosis. In addition, however, sequential changes in both the maximum QRS and T vector orientations in frontal and transverse planes were more often apparent than any sequential changes in the 12-lead electrocardiogram. While no specific 3 lead electrocardiographic criterion for pulmonary embolism could be determined, this technique was more helpful than conventional methods in following serial electrocardiographic changes in patients with this condition.
Transient airways obstruction associated with reduction in the transfer factor (diffusing capacity) of the lungs is reported in a patient with a clinical syndrome in keeping with extrinsic allergic alveolitis after exposure to Ramin dust (Gonystylus bancanus). The alterations in pulmonary function were consistently demonstrated on testing the patient in his working environment and were reproduced in the laboratory after inhalational challenge. The importance of the temporal relationship of changes in pulmonary function to contact with suspected allergenic material is emphasized.
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The nitroblue tetrazolium (N.B.T.) test was performed on patients in whom a differential diagnosis of pulmonary thromboembolism or lobar pneumonia existed. The mean N.B.T. score in healthy subjects was 6.4% (range 1%-15%). Patients with uncomplicated pulmonary thromboembolism showed a mean N.B.T. value of 7.5% (range 3%-12%). In patients with lobar pneumonia the mean N.B.T. score was 42.4% (range 21%-85%). These results suggest that the N.B.T. test is of value in the differential diagnosis of pulmonary thromboembolism and lobar pneumonia.
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