[Protracted vitamin D poisoning].
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Biomedical subjects
Publications and source records attributed to M Haataja.
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We studied the effect of interferon as an adjunct to conventional insulin therapy on the early course of Type 1 diabetes in 43 newly diagnosed patients. Compared with conventional therapy, interferon administration slightly delayed the improvement of glucose homeostasis and the rise of high density lipoprotein cholesterol, while C-peptide secretion was unaffected. Independent of the type of therapy, 18 patients (42%) entered partial remission. The remission began 2.0 +/- 0.6 months (mean +/- SEM) from the start of therapy and lasted for 4.1 +/- 1.1 months. Seven patients (16%) were still in remission 1 year after diagnosis. The patients who entered remission had higher initial C-peptide secretion, lower glycosylated haemoglobin levels and better initial control than patients without remission. Thus, interferon provided no benefits as an adjunct to conventional insulin therapy in unselected patients with newly diagnosed Type 1 diabetes. An important factor for the development of remission was the presence of C-peptide secretion at the time of diagnosis.
The effect of vaginal or cervical examination during pregnancy upon the levels of circulating prostaglandin precursors and other free fatty acids was investigated. Of 31 mothers coming to elective induction of labor, a plain vaginal examination was performed in 9 cases, the cervix was penetrated by a finger and the membranes were slightly swept off the uterine wall in 10 cases and an amniotomy was performed in 12 cases. The blood samples were collected before and 5 minutes after the procedure. No changes were observed in prostaglandin precursors or in other free fatty acid levels. Also the precursors/other fatty acids ratio was unchanged. The demonstrated changes in circulating prostaglandin levels after these procedures are not reflected in the circulating precursor levels.
The concentrations of free fatty acids which included prostaglandin precursors were investigated in a group of 54 healthy women coming to elective induction of labor. There were no differences between the concentrations of the fatty acids when the mothers were divided in two groups according to whether induction was successful or not. There were slightly more mothers with successful induction, who had the total prostaglandin precursor level above average than among mothers with unsuccessful induction (p less than 0.05). The rates of false positives or false negatives were so high, however, that this determination can not be clinically used in predicting the outcome of labor induction.
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Oestradiol and naproxen were compared in a double-blind, cross-over study of 20 women suffering from climacteric symptoms. Subjective symptoms were assessed before and after treatment. In addition, serum levels of prostaglandin precursors and of certain other free fatty acids were determined. Oestradiol was found to have a slightly more pronounced effect than naproxen on symptoms and on fatty acid levels. Nevertheless, a large number of the patients reported significant alleviation of their symptoms on naproxen. Some of the climacteric symptoms may thus be mediated by prostaglandins. In most patients the fatty acid levels decreased after treatment with both substances, but there were two exceptions. It is suggested that there may be two separate types of metabolic response to these drugs.
The serum levels of free fatty acids were determined before and after an oral dose of 1000 mg acetylsalicylic acid (ASA) during the 7-11th weeks of pregnancy in 11 women admitted to hospital for legal abortion and in 8 women admitted for operative (hysterectomy) treatment because of fibroids. Thirteen healthy women of reproductive age served as controls. The levels of linoleic, alpha-linolenic, myristic, oleic, palmitic and palmitoleic acids were significantly lower in pregnant women than in the hysterectomy group. The level of arachidonic acid was higher in the pregnant and hysterectomy groups than in controls. Serum free fatty acids had a negative correlation with the duration of pregnancy. ASA treatment tended to increase the levels of many fatty acids in serum. Serum arachidonic acid levels after ASA treatment correlated significantly with the salicylate concentrations in myometrium and the levels of most other fatty acids with the salicylate concentration in endometrium.
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The value of soft tissue radiography in assessing the activity of rheumatoid arthritis was investigated in 67 patients and correlated to the clinical activity of the disease. Soft tissue radiography using a technique for mammary radiography was combined with immersion. Radiologically demonstrated periarticular oedema was most closely correlated to clinical activity. A close correlation also existed between soft tissue radiographic lesions and 99Tcm accumulation in hands.
Twenty-six patients with rheumatoid arthritis were treated with sodium aurothiomalate (16 patients) and penicillamine (10 patients) for 9 months. During both treatment periods the content of serum sulfhydryl groups increased and erythrocyte sedimentation rate, rheumatoid factor titre and number of swollen joints decreased.
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Synovia and synovial fluid proteinases were determined in 21 patients with rheumatoid arthritis who were using different kinds of antirheumatic medications. Significantly lower cathepsin B1-like proteinase activity (only 10% of control) was found in the synovial fluid of patients with chloroquine treatment, and significantly lower neutral trypsin-substrate hydrolysing proteinase activity (about 30% of control) was found in the synovia of patients with phenylbutazone treatment. No significant differences were found with other medications: gold, indomethacin, cortisone, acetylsalicyclic acid. No definitive correlations between disease activity parameters and proteinase activities could be found.
The inter-relationships of 25 variables in 140 rheumatoid patients were studied. One group, consisting mainly of hematologic variables, was differentiated on the basis of its high correlation with disease activity. The second group consisted of CRP and rheumatoid factor, which had highly significant positive correlations with each other. The third group consisted of serum aspartate aminotransferase, serum creatinine, antistreptolysin titre and blood eosinophils. These relationships are discussed.
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25 cases of rheumatoid arthritis were investigated radiologically and clinically over a period of 3 months, using soft tissue radiograms of the hands and Lansbury's Activity Index. The soft tissue radiography technique was a new combination using molybdenum target mammographic equipment and immersion of the hands in a 2.5 cm layer of 1:1 ethanol-water solution, in order to reduce the uneven darkening of films. Periarticular oedema and progression of erosive and soft tissue changes were observed in clinically active cases. High scores for joint swelling and erosions were also registered in some clinically inactive cases. Determination of the rapid progression of erosive and soft tissue changes and the determination of periarticular hyperaemic oedema using special radiographic methods appear to be of some value in assessing the activity of rheumatoid arthritis.
In the present investigation the significance of various clinical and laboratory examinations (especially the S-SH-group level) in the evaluation of the activity of RA was assessed. The material comprised 140 patients with RA and 360 control patients or healthy control persons. The principal results can be summarized as follows: 1. Patients with RA have a decreased S-SH-group level, more decreased in patients with active disease. Also a change in the activity of RA is correspondingly followed by a change in the S-SH-group level. The S-SH-group level diminishes significantly with the advance of age also in healthy persons. These findings and the possible role of the S-SH-groups in the pathogenetic process of RA are discussed. 2. Highly significantly with Lansbury's activity index correlated the S-SH-groups, B-Platelets, S-Fe, B-Hb and patient's own assessment of the disease; and significantly correlated S-Haptoglobin, S-TIBC and Te-index. A summary of the correlations between some parameters studied is presented in Table LI. 3. As a result, an activity index based on six laboratory tests (ESR, B-Platelets, S-Fe, S-Haptoglobin, S-SH-groups, Te-index) is proposed for the estimation of the activity of RA.
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