To elucidate the pathophysiology of elevated blood pressure in hypercalcemic patients, we studied the plasma concentration of catecholamines and their major metabolites (as an index of sympathetic function) and the blood pressure response to norepinephrine infusion (vascular reactivity) in patients with primary hyperparathyroidism, in patients with primary hypertension, and in normal controls. In addition, we evaluated the hemodynamic response to calcium infusion in normotensive and hypertensive subjects. Plasma levels of both norepinephrine and epinephrine and the metabolites normetanephrine and dihydroxyphenyl-glycol were significantly higher in the hypercalcemic group than in the other two groups. Norepinephrine infusion increased blood pressure by 8.5 +/- 1.4 mm Hg in the control group, by 19 +/- 2 mm Hg in the hypercalcemic group and by 29 +/- 3 mm Hg in the primary hypertensive group. Infusion of calcium produced a significant rise in both systolic and diastolic blood pressures and in peripheral resistance in the hypertensives, whereas in the normotensive group only systolic blood pressure increased, associated with a rise in cardiac output. We conclude that the observed increased activity of the sympathetic nervous system in hypercalcemia could account for the elevation in blood pressure and the enhanced vascular reactivity could explain the hypertension in some patients with primary hyperparathyroidism.

Adult↗

PubMedDate not supplied

Treatment of acute maxillary sinusitis. Doxycycline and spiramycin with and without irrigation.

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Acute Disease↗

PubMedDate not supplied

The Diabetes time Management Questionnaire.

PURPOSE: The purpose of this study was to test the psychometric properties of the 49-item Diabetes Time Management Questionnaire (DTMQ) in individuals with diabetes. The DTMQ was designed to assess general time management skills and those specifically relevant to compliance to a diabetes healthcare regimen. METHODS: Participants completed the DTMQ; the Habits, Attitudes, and Knowledge Questionnaire of Diabetic Compliance (HAK); and the Diabetes Knowledge Schedule (DKS) to provide two indices of construct validity of the DTMQ. Three HAK items related to time management skills (HAK-TM) provided an index of concurrent criterion-related validity for the DTMQ. RESULTS: Test-retest stability reliability results were significant for DTMQ total and individual item scores. Concurrent criterion-related validity of the DTMQ was supported by a significant correlation with the HAK-TM items. Construct validity of the DTMQ was partly supported by significant correlations with the DKS and two HAK items measuring diet and exercise compliance. CONCLUSIONS: The results support the use of the DTMQ to assess the time management skills of individuals with diabetes.

Activities of Daily Living↗

PubMedDate not supplied

Treatment of acute maxillary sinusitis. IV. Ampicillin, cephradine and erythromycinestolate with and without irrigation.

Six groups, each containing 50 patients with acute maxillary sinusitis, were treated with ampicillin plus nasal decongestant, ampicillin plus irrigation, cephradine plus nasal decongestant, cephradine plus irrigation, erythromycinestolate plus nasal decongestant, erythromycinestolate plus irrigation. The diagnosis was radiologically established and the healing likewise radiologically assessed on the fifth, tenth and fifteenth day. Treatment was given for 10 days. All groups demonstrated a similar radiological healing except cephradine plus nasal decongestant which was inferior to the others. Contrarily, side effects were least frequent in the cephradine groups and most frequent in patients cured with ampicillin. The difficulty in choosing the best treatment is discussed in relation to such factors as therapeutic results, side effects, long-term consequences of antibiotic treatment, establishment of any bacterial etiology and penetration characteristics of antibiotics into the diseased sinus.

Acute Disease↗

PubMedDate not supplied

Treatment of acute maxillary sinusitis. V. Amoxicillin azidocillin, phenylpropanolamine and pivampicillin.

One hundred and seventy-five patients with clinical symptoms of acute maxillary sinusitis, the diagnosis confirmed radiologically by mucous membrane thickening and secretion, were consecutively allocated to four different treatment groups: amoxicillin, azidocillin, phenylpropanolamine, and pivampicillin. The cure course was followed up radiologically on days 5, 10, and 15. The outcome of treatment was somewhat more beneficial after 5 days for amoxicillin and after 10 days for azidocillin, but slightly less beneficial with phenylpropanolamine after 10 and 15 days. The numbers of side effects were similar for the different treatment groups. The four treatment modes in question are compared with 19 others previously used in a large material consisting of more than 1000 patients with acute maxillary sinusitis.

Amoxicillin↗

PubMedDate not supplied

[Differential diagnostic value of nephelometrically determined protein fractions in the synovial fluid].

Synovial fluids of patients suffering from rheumatoid arthritis and osteoarthritis with effusions of the knees were examined. Different parameters were evaluated out of the synovial fluid (immunglobulins, Complement-1Q,-3,-4, haptoglobins, alpha-1-anti-trypsin, alpha-2-macroglobulin, transferrin, ceruloplasmin, rheumatoid factors, total count of cells, and ragocytes) and out of the plasma (blood sedimentation rate). The proteins were analysed by a nephelometricturbidimetric automatic centrifugal analyser. All parameters have been tested by valuable statistical methods and correlated to each other. The results worked out proved the reliability of the used test kits and apparative systems. Correlations within groups of parameters according to their formations (intra-and/or extraarticular) could not have been worked out in a way as it may be supposed. In contrast some parameters themselves are statistically different comparing rheumatoid arthritis and osteoarthritis. In general the results are on a higher level in the rheumatoid arthritis group. Using all parameters mentioned above the statistical differential diagnostic level is based on about 94%. If only blood sedimentation rate, total cell count and ragocytes are evaluated the level is based on 68%.

Acute-Phase Proteins↗