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Biomedical subjects

S Juul

Publications and source records attributed to S Juul.

At least 73 records · Page 4Linked to original sources
PubMed1987

Usefulness of ST deviation induced by prolonged hyperventilation as a predictor of cardiac death in angina pectoris.

One hundred ninety patients with chronic angina for an average of 2 years were followed. Forty-seven had at least 1 mm of ST deviation in response to provocation of coronary vasoconstriction by prolonged hyperventilation (group I); 143 had no ST deviation (group II). The angiographic response to this test was studied in 21 patients from group I, and revealed 25 to 100% diameter reduction; in group II 9 patients showed a 5 to 14% diameter reduction. In group I, 15 patients (32%) died (hazard rate = 0.17 deaths/patients X years) vs 18 (13%) in group II (hazard rate = 0.06) (p less than 0.01). Seven patients in group I (15%) and 3 in group 2 (2%) died while waiting for surgery (p less than 0.01). All patients who died had coronary stenoses of at least 70%. A Cox regression analysis, using 24 variables (invasive and noninvasive), showed a positive hyperventilation test (ST deviation at least 1 mm), low ejection fraction and systolic blood pressure of at least 160 mm Hg to be independent predictors of death (p less than 0.05). Considering only deaths in non-operated patients (patients waiting for surgery and patients not planned to undergo operation), a rate-pressure product/100 of 150 or less at exercise stress testing, left ventricular end-diastolic pressure of 15 mm Hg or more and duration of angina less than 1 year were also independent predictors of death. Thus, the hyperventilation test may be useful for identifying angina patients who are at high risk of cardiac death due to dynamic coronary obstructions.

Adult↗
PubMed1984

Variation and information in white blood cell differential counts.

The magnitude and sources of variation in the white blood cell (WBC) count and differential count affect their information content and clinical value. This study describes components of variation in the WBC count and differential, estimates the magnitude of each component, and uses computer simulations to compare the information conveyed by the total WBC count and by the WBC differential count, expressed as the number of each type of cell and as the percentage of each cell type. Biologic variation is much greater than statistical sampling variation in differential WBC counts, even when a relatively small number of cells is classified. The commonly reported neutrophil percentage is inferior both to the neutrophil count and to the total WBC count in its ability to detect neutrophilia and to detect recovery from elevated levels. This conclusion holds for single as well as for sequential WBC differential determinations and regardless of the level of test result at which the clinician considers disease to be present. The total WBC count and the neutrophil count differ little in performance, so a neutrophilic patient's return to normal levels can safely be detected and monitored by relying on the less expensive total WBC count and foregoing repeated requests for differential counts.

Bacterial Infections↗
PubMed1980

Prognosis and treatment of abdominal aortic aneurysm.

The records of 109 patients operated upon for ruptured or nonruptured abdominal aortic aneurysms in the period from 1961 to 1975 were analyzed, with special attention being given to hospital mortality and the long term survival rate. It was found that a hospital mortality of 67 per cent occurred in patients operated upon for ruptured aortic aneurysms as well as a lethality rate of 40 per cent for patients operated upon urgently for nonruptured aortic aneurysms, whereas the lethality rate was only 4.5 per cent for patients operated upon electively. Subsequent to surgical treatment, an imposingly high mortality occurred in both groups of patients in relation to the normal population, so that only about 10 per cent of the patients operated upon for abdominal aortic aneurysms were living after a period of eight years. The most frequent causes of death in both groups of patients were illnesses resulting from other cardiovascular manifestations or complications in connection with the implanted prosthesis. By optional operation of the nonruptured aortic aneurysm, a gain in the number of patient years could be obtained within the first five years after the operation. However, careful evaluation of the cardiovascular status of the patient is recommended before deciding upon an operation.

Aged↗
PubMed1978

Mechanism of action of insulin in diabetic patients: a dose-related effect on glucose production and utilisation.

Six insulin-requiring diabetics were studied after insulin had been withheld for 24 hours. On three separate occasions each received a two-hour infusion of insulin at a low dose (2.6 U/h) and a high dose (10.6 U/h) and an infusion of saline as control. The rates of production and utilisation of glucose were measured isotopically. The rate of fall of plasma glucose concentration was faster on the high-dose infusion of insulin than on the low, whereas the fall in plasma free fatty acids, glycerol, and keton bodies was the same on both insulin infusions. The mechanism whereby the two rates of insulin administration lowered plasma glucose concentration differed: during the low-dose infusion the decrease in the glucose concentration was produced entirely by a fall of hepatic glucose output, whereas during the high-dose insulin infusion the glucose concentration fell because both the rate of glucose production fell and the rate of glucose utilisation rose. In all experiments there was a direct relation between a fall in serum potassium concentration and the fall in plasma glucose concentration irrespective of the mechanism that reduced the glucose concentration.These results indicate that in uncontrolled diabetics low-dose insulin infusions lower the blood glucose concentration entirely by reducing glucose production from the liver and that the effect of insulin on potassium transport is independent of its effect on glucose uptake.

Adult↗