[The hematological side effects on antihypertensive drugs].
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Biomedical subjects
Publications and source records attributed to B Magnusson.
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The quinoline color D & C Yellow No. 11 was added to a standard test series. Of 88 patients tested with 1% in PEG, four showed unexplained positive test reactions. One patient had a "flare-up" reaction after 14 days. At rechallenge he reacted to a dilution down to 0.00001%. Simultaneous reaction with the chemically related commonly used food color Quinoline Yellow (E 104) suggests cross-sensitivity.
The influence of one week's treatment of fluproquazone, 300 mg daily, and acetylsalicylic acid (Aspirin, Bayer), 3000 mg daily, on the gastro-intestinal tract and coagulation factors was compared in a randomized cross-over study in 12 healthy male volunteers. Gastroscopy revealed two acute erosions after fluproquazone in one subject, whereas 11 of the 12 subjects showed a total of about 80 erosions, petechiae or diffuse bleeding after aspirin. Median faecal blood loss, as assessed by means of 51Cr tagging and measurement of bulk radioactivity in a whole-body counter, were significantly (p less than 0.01) raised, from 1.8 (range 0-6.5) ml during the preceding control week to 6.0 (range 1.9-10.5) ml after treatment with aspirin. No significant difference was recorded between control and treatment weeks with fluproquazone. Mean bleeding time was significantly increased by 40% with aspirin, whereas no statistically significant change was observed with fluproquazone. The prostaglandin synthesis was not significantly influenced by fluproquazone but was almost completely suppressed by aspirin. Coagulation factor II-VII-X decreased slightly, but remained within the normal range with both drugs. This study demonstrated a markedly smaller effect of fluproquazone compared with aspirin on the gastro-intestinal tract and on haemostatic factors.
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The absorption from a 3 mg dose of ferrous iron was measured in 250 male subjects. The absorption was related to the log concentration of serum ferritin in 186 subjects of whom 99 were regular blood donors (r = -0.76), and to bone marrow haemosiderin grading in 52 subjects with varying iron status. The purpose was to try and establish a percentage absorption from such a dose that is representative of subjects who are borderline iron deficient. This information is necessary for food iron absorption studies in order (1) to calculate the absorption of iron from the diet at a given iron status and (2) compare the absorption of iron from different meals studied in different groups of subjects by different investigators. The results suggest that an absorption of about 40% of a 3 mg reference dose of ferrous iron is given in a fasting state, roughly corresponds to the absorption in borderline-iron-deficient subjects. The results indicate that this 40% absorption value corresponds to a serum ferritin level of 30 microgram/l and that food iron absorption in a group of subjects should be expressed preferably as the absorption corresponding to a reference-dose absorption of 40%, or possibly a serum ferritin level of 30 microgram/l.
A case of alprenolol-induced thrombocytopenia in a 65-year-old woman is reported. She was admitted to the hospital twice with platelet counts below 10X10(9)/l. The platelet count rapidly returned to normal after discontinuation of alprenolol. The reason for the thrombocytopenia was increased platelet destruction.
Metallic restorations are corroded in the oral environment. Corrosion products penetrate into the tissues and are distributed throughout the body seeking certain organs and tissues as targets. The distribution patterns of nickel in albino mice were studied autoradiographically at various periods after an intravenous injection of 63Ni in order to locate the target organs and tissues of nickel. With short survival periods the highest uptake of 63Ni was found in the blood, kidney, urinary bladder, lung, eye and hair follicles. With long survival periods, 3 weeks, the distribution pattern was dominated by high uptake in the lung tissues, central nervous system, kidneys, hard tissues and skin. The distribution pattern in brown mice was similar to that in albino mice. However, the concentration in the eye and the skin was more pronounced. The importance of release of nickel from nickel containing dental alloys in nickel allergic patients is discussed.
Guinea pig testing constitutes the first step in evaluating the allergenicity of new chemicals and products. Some of the most commonly used animal predictive tests are reviewed. The guinea pig maximization test, which is the recommended test method in Sweden, is described in detail and the interpretation of results obtained with this test is discussed. In the guinea pig maximization test the sensitization capacity of a substance is examined by the use of maximized conditions for the exposure, i.e. the potential ability of the material to induce a contact allergy is determined. The extent to which an allergen causes contact dermatitis in exposed persons depends on the mode of use and various environmental factors.
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Out of 134 patients patch tested after total hip replacement (metal-to-plastic) 13 were sensitive to one or two of the implanted metals. In a prospective series of 112 patients, nine were sensitive to nickel before and another three developed sensitivity to nickel or cobalt after the arthroplasty. In the retrospective as well as in the prospective series the complications could in all cases but one be explained on grounds other than allergy. The incidence of contact allergy to nickel before a planned arthroplasty was 12 per cent in females and 4 per cent in males. It is doubtful whether metal sensitivity could be induced by a total hip arthroplasty. However, in cases of a preexisting metal allergy, a certain degree of caution is recommended.
In 1961--1962 five families including 53 members with a familial form of cardiomyopathy (CMP) were examined. Fifteen years later a reinvestigation of the previously examined families was carried out using community registers; mortality as well as new family members were registered. Another 50 family members were thereby added. Three out of 6 young subjects who were diagnosed as having definite (2) or suspected (1) CMP at the initial examination died during the follow-up period. Four of the five families, totalling 39/41 members, were given a thorough noninvasive clinical examination including ECG, phonocardiogram exercise test, measurement of systolic time intervals and carotid arterial pulse curves, and echocardiography (Echo). A high number (17/39) of suspected or definite pathologic echocardiographic changes consistent with CMP was observed on reinvestigation. Eleven of these 17 were asymptomatic. Except for Echo, the non-invasive methods used in this study did not contribute to the diagnosis of CMP, but the non-Echo methods confirmed the Echo findings in those patients with symptoms of cardiac disease. The four reexamined families revealed a very heterogenous pattern of CMP, with both symmetric and asymmetric hypertrophy (ratio symmetric/asymmetric = 15 : 2). It may be questioned whether asymptomatic subjects with borderline changes, indicative of symmetric hypertrophy, will develop definite symmetric CMP or whether their symptoms constitute an early stage of asymmetric CMP. Echocardiographic findings may well fit with the theory of a dominant mode of inheritance.
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Iron absorption from a composite meal was studied in 37 male patients before and 1 year after parietal cell vagotomy (PCV) and selective vagotomy with pyloroplasty (SV + P) in a prospective randomized series. The ability to absorb dietary non-haem iron was studied by relating in each subjects the food iron absorption to the absorption from a small dose of ferrous iron, which has been shown to be unaffected by gastric surgery. After both PCV and SV + P there was a malabsorption of food iron which was statistically significant in patients with increased iron requirements caused by phlebotomy. Malabsorption of food iron was less marked after PCV and SV + P than in patients after gastric resection, and it is concluded that there may be no need for a general prophylactic iron supplementation in patients operated on with PCV and SV + P.
Patch tests with a standard series were performed in 274 non-dermatologic patients undergoing orthopedic surgery. Allergic reactions were observed in 22%, particularly to nickel (7%) and balsam of Peru (5%). Contact allergy in patients without previous or present skin disease was observed in 9%. A certain frequency of contact allergy in the general population should be held in mind when considering the incidence in patients with skin disease.
Four hundred and eighty-five primary malignant skin tumours submitted for histological diagnosis in Iceland during the period 1955--1974 were typed according to the WHO histological classification. The incidence of these tumours, age-adjusted to the "World" population, was 12.6/100.000 in males and 11.0/100.000 in females. These are very low figures for a white population. The distribution by type among males was: basal cell carcinoma 66.8%, squamous cell carcinoma 22%, malignant melanoma 7.2% and others 4%. Among females: basal cell carcinoma 66.9%, malignant melanoma 20.8%, squamous cell carcinoma 10.2% and others 2.1%. The exposed areas of the body were affected much more frequently than other areas. The results support the theory that intensity of solar radiation is of major aetiological significance.
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Benzocaine-reactive patients were patch tested to two commercial sources of glyceryl p-aminobenzoate containing varying concentrations of benzocaine as a contaminant. Eleven of 20 reacted to the source with approximately 0.3% benzocaine; none reacted to the source with approximately 0.001% benzocaine.