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Biomedical subjects

J Salmi

Publications and source records attributed to J Salmi.

11 recordsLinked to original sources

Inhaled beclomethasone decreases serum osteocalcin in postmenopausal asthmatic women.

There are very few data as yet to quantify the effect of inhaled corticosteroids on bone metabolism, although the use of these drugs as a first-line treatment in bronchial asthma has widened. We determined the effect of three dose levels (200, 1000, 2000 micrograms/day, three weeks each) of inhaled beclomethasone on specific characteristics of bone metabolism in nine postmenopausal women with new asthma without any previous corticosteroid therapy. Significant decrease was noted in the mean serum morning osteocalcin concentration between the baseline and after nine weeks of beclomethasone (from 4.4 to 3.1 micrograms/l, p = 0.005). Significant increase in serum total and ionised calcium was found, although the parameters measuring bone resorption itself did not change. The results show that especially high-dose inhaled beclomethasone decreases serum osteocalcin in post-menopausal asthmatic women. Further studies are needed to assess the effects of inhaled beclomethasone, both on the ability of the osteoblasts to form bone matrix and on the density of bone during a longer treatment period on inhaled corticosteroids.

Administration, Inhalation

Postoperative hyperglycaemia--are the patients diabetic?

The aim of this study was to investigate the occurrence and causes of postoperative hyperglycaemia. Blood sugar was measured after operation in 262 patients who had undergone minor emergency operations, when the patients were receiving 5% glucose infusion at the rate of 170 ml/h. In 32 patients (12%) blood glucose was over 8.0 mmol/l. Serum insulin concentration in these patients was significantly higher than in reference patients, who had blood glucose below 5.5 mmol/l. The number of insulin receptors in red cells and the affinity of insulin to receptors were similar in both groups. Serum cortisol was higher, but free fatty acid concentration lower, in the hyperglycaemic group than in the reference group. The tests done postoperatively were repeated two weeks later without surgical stress. The values recorded, indicating the patients' normal metabolism, did not differ between the two groups, except that serum cortisol was somewhat higher in the reference patients. The oral glucose tolerance test was normal in all patients except one. The results suggest that patients prone to postoperative hyperglycaemia are not diabetic, but that their production of glucose is increased during surgical stress.

Adult

Performance of two agglutination techniques in the detection of thyroid antibodies and assessment of their clinical significance.

Two clinically most widely used agglutination tests, Thymune and Serodia distributed by Wellcome and Fjirebio/Ames, respectively, to determine thyroid autoantibodies were compared. The Serodia tests seemed to be considerably more sensitive than the corresponding Thymune tests; first, Serodia tests resulted in several new positive samples and second, 16% and 30% of positive thyroglobulin and thyroid microsomal antibodies by Serodia resulted in at least 16 times higher titres, respectively. Over 300 healthy blood donor sera were used to determine the occurrence of thyroid autoantibodies in normal population. Titre limits of 400 and 6400 in anti-thyroglobulin and anti-microsomal antibodies were adapted for clinical use, respectively, even though the results suggested that the lower titre limits could be applied for males and subjects younger than 40 years. These defined titre limits were applied to examine randomly selected clinical patient material gathered during 1 year. The main patient groups identified included patients with chronic thyroiditis, thyroid malignancy, diabetes. Graves' disease and rheumatoid diseases as well as patients with vaguely defined clinical conditions. Without the aid of antithyroglobulin antibodies only one patient with chronic thyroiditis would have been missed if thyroid microsomal antibodies were used alone. Thus, in general clinical practise thyroid microsomal antibodies can be used as a sole diagnostic test for autoimmune thyroid diseases.

Adult

Pituitary function after pituitary apoplexy.

Pituitary function was studied in nine patients who had recovered from pituitary apoplexy. All the patients recovered spontaneously; none required immediate surgery. Four of the patients had acromegaly, two had pituitary-dependent Cushing's syndrome, and a "functionless" pituitary adenoma was found in three. Low serum growth hormone concentrations were observed in three patients with acromegaly whereas the concentration remained increased in the fourth one. Of the two patients with Cushing's syndrome, a selective ACTH-deficiency developed in one and Nelson's syndrome appeared with excessive secretion of ACTH in the other. Transient or persistent hypofunction of the anterior pituitary occurred in al patients. Three patients underwent hypophysectomy after respective intervals of three, eight and 12 months after pituitary apoplex. The operation revealed a hemorrhage in one functionless adenoma and a large cyst in another one. In the third patient who had acromegaly, no signs of the pituitary apoplexy were observed at operation.

Acromegaly