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Biomedical subjects

H Flax

Publications and source records attributed to H Flax.

At least 19 recordsLinked to original sources
PubMed1992

Treatment of familial hypercholesterolaemia. United Kingdom lipid clinics study of pravastatin and cholestyramine.

OBJECTIVE: To compare the efficacy and safety of cholestyramine, an anion exchange resin, and pravastatin, a new hydrophilic specific inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase, in the treatment of heterozygous familial hypercholesterolaemia. DESIGN: Double blind, double dummy, placebo controlled study with three parallel groups. SETTING: Six specialist lipid clinics in the United Kingdom. PATIENTS: 128 patients aged 18-70 with heterozygous familial hypercholesterolaemia diagnosed on strict biochemical and clinical findings. MAIN OUTCOME MEASURES: Total plasma cholesterol, triglyceride, and lipoprotein subfractions and biochemical and haematological safety parameters. RESULTS: Pravastatin (40 mg/day) led to a 25% reduction in total plasma cholesterol concentration and a reduction in low density lipoprotein cholesterol concentration of 30%. Cholestyramine (24 g/day) led to similar reductions in concentrations of total cholesterol (23%) and low density lipoprotein cholesterol (31%). No consistent changes occurred in high density lipoprotein cholesterol values with either compound. Plasma triglyceride concentrations showed a small rise (18%) on resin therapy. No serious adverse drug reactions occurred during the study. CONCLUSIONS: Pravastatin seems to be a highly effective, well tolerated drug for severe hypercholesterolaemia. Patients chosen for this study were recruited on the basis that they could tolerate a full dose of cholestyramine, and in this situation cholestyramine was also highly effective in lowering plasma low density lipoprotein cholesterol concentrations.

Adolescent↗
PubMed1991

No glucotoxicity after 53 hours of 6.0 mmol/l hyperglycaemia in normal man.

In vitro and in vivo studies have suggested that metabolic deterioration can be induced by hyperglycaemia per se. The effect of 53 h of 2.2 mg glucose.kg ideal body weight-1.min-1 was examined in four normal male subjects. This produced overnight hyperglycaemia of 6.0 mmol/l on the two nights of the study compared with 4.7 mmol/l on the control night (p less than 0.05). In response there was a sustained, two-fold increase in basal plasma insulin (p less than 0.005) and C-peptide (p less than 0.05) levels. After two days of hyperglycaemia an increased Beta-cell response was demonstrated in response to an additional glucose infusion stimulus (estimated Beta-cell function median of 84% on the control day to 100% after two days glucose infusion). Plasma insulin and C-peptide responses to a 10.0 mmol/l hyperglycaemic clamp increased over the two days of the study (insulin from median 48 mU/l to 73 mU/l and C-peptide from median 2.0 pmol/ml to 2.6 pmol/l). Glucose tolerance to the additional glucose infusion stimulus improved, suggesting that the increased insulin response during hyperglycaemia was enhancing peripheral glucose uptake. The calculated peripheral insulin sensitivity was unchanged during the hyperglycaemic clamp. Thus, in response to the two days of basal hyperglycaemia, both the basal and stimulated Beta-cell responses were enhanced and there was no evidence for 'glucose toxicity' to the Beta-cells.

Adult↗
PubMed1990

Nonmucosal predominantly serosal eosinophilic enteritis. A case report.

A unique case of eosinophilic enteritis with predominant serosal involvement and mucosal sparing, ascites and abdominal adenopathy is reported with computed tomography (CT) and barium study correlation. The clinical presentation may mimic lymphoma or granulomatous disease, (e.g. tuberculosis) but peripheral eosinophilia is a strong differentiating point.

Adult↗
PubMed1990

Diabetes associated with Guillain-Barre syndrome.

Transient diabetes is not recognized as one of the known metabolic complications of acute inflammatory polyradiculopathy or Guillain-Barré syndrome (GBS). Four patients are described who developed this disorder during the paralytic phase of their illness and one who was hyperinsulinaemic but not hyperglycaemic. The mean age of the patients was 34.4 yr. No patient received steroids and three were ventilated. The mean cerebrospinal fluid protein concentration was 1.6 g/l. Two patients required short term insulin therapy. Four had intravenous glucose tolerance tests performed acutely (AP) and after one month (1 M). Three had a repeat study after long term follow-up. One subject had increased his Body Mass Index from 23.8-26.8 and therefore his IVGTT reflected insulin resistance. The other three patients had elevated basal glucose during GBS and similar first phase glucose response to IVGTT. The mean fasting glucose was 6.9 mmol/l (AP), 3.9 mmol/l (1 M) and 4.4 mmol/l at 6 yr. The mean fasting insulin was 114.9 pM/l (AP), 114.9 pM/l (1 M) and 25.9 pM/l (6 yr). The mean fasting C-peptide was 1.3 nmol/l (AP), 1.0 nmol/l (1 M) and 0.5 nmol/l (6 yr). Homeostatic modelling of the paired insulin and C-peptide data show a trend consistent with the hypothesis that insulin resistance is the dominant feature of impaired glucose tolerance in Guillain-Barre syndrome.

Adolescent↗
PubMed1987

Reactive thrombocytosis in pulmonary tuberculosis.

The incidence of reactive thrombocytosis in active pulmonary tuberculosis was studied in 122 patients. Thrombocytosis was common, platelet counts often exceeding 1 X 10(12)/1. A significant inverse correlation was noted between the mean platelet volume and the platelet count (r = -0.54, p less than 0.0001). Interval estimation suggested that this relation was non-linear. Further studies were done in a small group of six patients. Platelet survival was considerably shortened, the platelets aggregated excessively in vitro, serum concentrations of thrombopoiesis stimulating activity were raised, and serotonin uptake and release were within normal limits. The degree of thrombocytosis correlated significantly with the degree of inflammation measured by the erythrocyte sedimentation rate (r = 0.40, p less than 0.003) and serum C-reactive protein concentration (r = 0.35, p less than 0.008).

Arachidonic Acids↗
PubMed1986

Red blood cell distribution width in the anemia secondary to tuberculosis.

A study was done to explore the claim that anisocytosis as measured by the red blood cell volume distribution width (RDW) is raised in iron-deficiency anemia, but is normal in the anemia of chronic disorders. Measurements were done on 283 normal patients, 22 iron-deficient patients, and 102 tuberculotic patients, using a model S plus Coulter Electronic Counter with standard calibration. Mean (+/- SD) values for RDW were as follows: normals, 7.36 (+/- 0.57); untreated iron deficiency, 10.39 (+/- 1.37); and 15 untreated anemic patients with tuberculosis, 10.44 (+/- 0.63). Mean values remained above 10.4 in 69 patients with tuberculosis during treatment, irrespective of whether or not the patients were anemic, but had fallen towards the normal mean (8.49 +/- 0.8) in the 18 subjects in whom it was measured at the end of therapy. By this time the mean corpuscular volume (MCV) and hemoglobin concentrations had risen to normal. It is concluded that RDW values in the chronic inflammatory disorder tuberculosis are not significantly different from those occurring in iron-deficiency anemia.

Anemia↗
PubMed1986

Haematological and iron-related measurements in active pulmonary tuberculosis.

59 patients with active pulmonary tuberculosis were evaluated in terms of haematological indices, iron-related measurements and markers of inflammation. The variables evaluated included the Hb, mean cell volume (MCV), serum iron, total iron-binding capacity, percentage saturation, serum ferritin, erythrocyte sedimentation rate (ESR) and C-reactive protein. In addition, marrow iron stores were assessed both histologically and chemically. Among the changes noted was a raised S-Ferritin, which appeared in part to be a component of the acute phase response, since it correlated with C-reactive protein concentration (r 0.59, p less than 0.0001). In addition, there was a good correlation between the S-Ferritin and the concentrations of non-haem iron in the marrow, as assessed chemically on trephine biopsies (r 0.78, p less than 0.0001) and histologically on aspirated and biopsy material (rS 0.78, p less than 0.0001 and rS 0.68, p less than 0.0001, respectively). Furthermore, the quantitative relationship between the S-Ferritin and the chemical concentrations of non-haem iron in the marrow was similar to that found previously in a heterogeneous group of subjects without infections. While the present findings confirm that iron is diverted into reticuloendothelial stores in active pulmonary tuberculosis, no evidence was found to suggest that the anaemia which was present in 45 of the 59 patients was secondary to iron-deficient erythropoiesis; the percentage saturations in the 2 groups were 30.3 and 31.1 respectively. In a final analysis, the present findings were compared with previous ones obtained in a group of patients with Hodgkin's disease. The degree of rise in the S-Ferritin for a given marrow non-haem iron concentration was significantly less in the patients with tuberculosis (p less than 0.0001).

Adult↗
PubMed1985

Multicentric giant lymph node hyperplasia, Kaposi's sarcoma, and lymphoma.

We studied two cases of a recently recognized systemic lymphoproliferative disease with morphological features of Castleman's disease: multicentric giant lymph node hyperplasia. Both patients developed Kaposi's sarcoma and had laboratory evidence of immune abnormalities, including reversed T4 to T8 ratios. One patient's disease had a subacute course with fevers of unknown origin, mucocutaneous candidiasis, and progressive thrombocytopenia, while the other patient's disease had a fulminant course with anemia, thrombocytopenia, and splenic lymphoma. Both patients were elderly, and both died of complications of multicentric giant lymph node hyperplasia.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Hypertrophic cardiomyopathy in South African Blacks.

Hypertrophic cardiomyopathy (HCM) has been considered rare among the Black population of southern Africa. We report 7 patients with the disease who presented during a 14-month period. Current concepts in the approach to the diagnosis and treatment of HCM are discussed. It is possible that with greater awareness of the occurrence of the condition in Blacks the diagnosis of HCM will be made in more members of this population group.

Adult↗
PubMed1982

Long-term captopril therapy in severe refractory congestive heart failure.

1 The favourable haemodynamic effects of captopril in patients with congestive heart failure have been reported. 2 We have treated 25 patients with severe chronic congestive heart failure with captopril in doses of 75-450 mg daily. Before entering the study all patients remained in New York Heart Association functional class IV despite high-dose diuretic and vasodilator therapy. 3 Mean cardiothoracic ratio was 60%, and all patients had a shortening fraction of 18% or less on echocardiography (normal 25 to 40%). 4 Five patients died within one month of captopril and five between four and seven months, three of whom had improved to class IIM and one to IIS before death. 5 Of the 15 survivors one was referred for a heart transplant when he had improved to class IIM. The remaining 14 patients were followed for 8-16 months. Ten improved to New York Heart Association class I or IIS and four to class IIM or III. Diuretic requirements were decreased considerably in all 14. Side effects were common but captopril did not have to be withdrawn. Captopril is a highly effective drug in the treatment of patients with congestive heart failure refractory to currently accepted therapy.

Adolescent↗
PubMed1974

Effects of haemoperfusion through charcoal or XAD-2 resin on an animal model of fulminant liver failure.

In a group of dogs in whom fulminant liver failure had been induced, perfusion of blood through activated charcoal resulted in a significantly longer survival than that of a similar group of dogs whose blood was not so treated. An otherwise progressive rise in blood ammonia concentration was halted in the treatment group. In another group of dogs with fulminant liver failure perfusion of blood through the resin Amberlite XAD-2 was associated with a fall in the serum bilirubin concentration and complete clearance from the blood of (14)C-labelled sodium glycocholate. Survival in this group of animals was not significantly prolonged. This was due at least in part to the occurrence of haemorrhage due to thrombocytopenia. Platelets adhere to the resin but do not adhere to the same degree to charcoal coated with a thin layer of polymer.

Ammonia↗