Abstract:
:Patients with coronary atherosclerosis present with angina, myocardial infarction and sudden death, most often caused by atherosclerotic stenosis complicated by spasm and/or occlusive thrombosis. All of these events have been shown to exhibit similar diurnal rhythms, with a peak incidence in the morning after waking and rising. Other cardiovascular parameters also show a similar diurnal rhythm associated with increased sympathetic outflow and circulating catecholamines, producing increases in heart rate, blood pressure, myocardial contractility and oxygen demand soon after waking and rising. Experimental and clinical research has recently pointed to several possible mechanisms that might be responsible for these events. In patients with atherosclerosis, dysfunction of the endothelium in the epicardial coronary arteries results in a failure to limit the constrictor response to catecholamines. Catecholamines can also alter the procoagulant nature of vascular surfaces. We speculate that the interaction between increased sympathetic activity and the procoagulant and vasoconstrictor states of atherosclerotic coronary stenoses may lead to a lower threshold to ischaemia in the waking hours, with a corresponding increase in angina, myocardial infarction and sudden death. These factors may be important considerations for the selection of suitable therapies and for future research.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Selwyn AP,Raby K,Vita JA,Ganz P,Yeung Asubject
Has Abstractpub_date
1991-01-01 00:00:00pages
S44-7eissn
0032-5473issn
1469-0756journal_volume
67 Suppl 5pub_type
杂志文章,评审abstract:OBJECTIVES:To explore the relationship between cognitive impairment and conventional measures of disability in multiple sclerosis (MS), quality of life (QOL) and employment status using the brief international cognitive assessment for multiple sclerosis (BICAMS) in the routine outpatient clinic. METHODS:62 patients wi...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2016-134071
更新日期:2017-03-01 00:00:00
abstract::Liver transplantation is a useful treatment for end stage liver disease of all aetiologies but recurrent disease presents an ongoing challenge, particularly for hepatitis C virus (HCV) where recurrence is almost universal. Immunosuppression is needed for all patients after transplantation and should be tailored to the...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2005.034082
更新日期:2005-12-01 00:00:00
abstract::Five cases of primary peritonitis are presented, with a sixth related case of pneumococcal peritonitis secondary to a ruptured ovarian cyst. The patients comprised 4 young girls who recovered, and 2 elderly females who died. Pneumococci were isolated in 3 patients; no organism was found in the other 3. One case of pri...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.59.687.21
更新日期:1983-01-01 00:00:00
abstract::Three patients with lung carcinoid related Cushing's syndrome (LCRCS) treated at Frenchay Hospital, Bristol between 1984 and 1994 are described. The first patient presented with hyperpigmentation 13 years after bilateral adrenalectomy. The second patient had no recurrence or metastases 14 years after removal of a typi...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pmj.77.909.464
更新日期:2001-07-01 00:00:00
abstract::Psoriasis (PsO) is a chronic skin disease. This study aims to evaluate clinical and subclinical response to calcipotriol+betamethasone foam, in patients with PsO, comparing, for the first time, data from microvascular ultrasound (MicroV) and shear wave elastography (SWE) with Psoriasis Area and Severity Index (PASI). ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2020-138150
更新日期:2021-01-01 00:00:00
abstract::Two patients with a rise in cardiac troponin T (cTnT) concentrations during the course of lobar pneumonia, without any evidence of acute coronary syndrome or renal failure, are presented. The increase in cTnT concentration is considered a highly sensitive marker of cardiac injury, although it may also rise in other co...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.78.918.244
更新日期:2002-04-01 00:00:00
abstract:AIMS:To review the clinical and pathological factors associated with fulminant amoebic colitis (FAC) requiring colonic resection and its outcome. METHODS:We retrospectively identified adult patients admitted to our centre between June 2007 and December 2011 with FAC who underwent colonic resection and were diagnosed w...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2014-132597
更新日期:2015-04-01 00:00:00
abstract::In 40 hypertensive patients continuous ECG recording was done before and after 30 days treatment with indapamide 2.5 mg. There was no change in heart rate. In addition, the incidence of extrasystoles was not changed in patients in whom the ECG was normal before treatment (30 cases) or in 8 of the 10 patients who had a...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract::A young man developed acute renal failure and hypercalcaemia following severe burns. The hypercalcaemia was initially controlled by haemodialysis, but it persisted after return of renal function. Plasma PTH was inappropriately elevated, but the nephrogenous cyclic adenosine monophosphate level was low; thus the PTH wa...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.62.727.395
更新日期:1986-05-01 00:00:00
abstract::We present an unusual case of extreme metabolic alkalosis resulting from severe hypokalaemia caused by unmonitored fludrocortisone therapy. Biochemical aspects of the disorder are discussed, as is the successful treatment with diuretics and potassium replacement. Some dangers of this therapy and necessary precautions ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.59.694.506
更新日期:1983-08-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:Cincinnati Children's Hospital Medical Center created the Intermediate Improvement Science Series (I(2)S(2)) training course to develop organisational leaders to do improvement, lead improvement and get results on specific projects. DESIGN METHODS:Each multidisciplinary class consists of 25-30 par...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2012-000890rep
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:There are wide variations in survival after cardiopulmonary resuscitation. The aim of this survey was to describe how equipment provision of resuscitation trolleys was deployed in a range of clinical ward areas. METHODS:The equipment in randomly selected resuscitation trolleys in all 14 South West Thames Re...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,多中心研究
doi:10.1136/pgmj.2004.026930
更新日期:2005-06-01 00:00:00
abstract::Oral vitamin B12 can provide an effective alternative to intramuscular injections, so giving patients a choice and reducing costs in primary care. This study investigated the effectiveness, safety, and acceptability of oral vitamin B12 as replacement therapy in patients with vitamin B12 deficiency in a city general pr...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.79.930.218
更新日期:2003-04-01 00:00:00
abstract::Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has spread in nearly 200 countries in less than 4 months since its first identification; accordingly, the coronavirus disease 2019 (COVID 2019) has affirmed itself as a clinical challenge. The prevalence of pre-existing cardiovascular diseases in patients wi...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/postgradmedj-2020-138080
更新日期:2020-07-30 00:00:00
abstract::Postgraduate medical education (PME) quality assurance at Health Education England (HEE) currently relies upon survey data. As no one metric can reflect all aspects of training, and each has its limitations, additional metrics should be explored. At HEE (West Midlands), we explored the use of learner outcomes, special...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2020-138669
更新日期:2020-11-12 00:00:00
abstract::Patients with acquired von Willebrand disease may present with severe bleeding, which is usually difficult to manage. Adequate haemostasis in acquired von Willebrand disease may be achieved with the infusion of factor VIII/von Willebrand factor concentrates or with the administration of desmopressin. We report a case ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.70.830.916
更新日期:1994-12-01 00:00:00
abstract::Fasting plasma and urinary calcium and urinary hydroxyproline are known to rise at the menopause, reflecting increased bone resorption. Oestradiol valerate and cyclic oestradiol valerate/DL-norgestrel are shown to reduce this evidence of increased bone loss. It is concluded that these preparations will be effective in...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::Eosinophilic gastroenteritis is a condition characterised by eosinophilic infiltration of the gastrointestinal tract. Biliary obstruction is an unusual presentation. A case where the initial investigations were consistent with carcinoma of the head of pancreas but the resection specimen showed no malignancy is present...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.78.922.498
更新日期:2002-08-01 00:00:00
abstract::Focused assessment with sonography in trauma (FAST) is a limited ultrasound scan performed in the emergency department to assess patients admitted with blunt abdominal trauma (BAT). It is normally undertaken by emergency physicians in order to identify the presence of free fluid, which may represent haemoperitoneum. T...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2008.076711
更新日期:2010-05-01 00:00:00
abstract::This paper reviews the adverse events reported by 12,917 patients treated with cephalexin in formal clinical trials. Six percent of all patients reported adverse events, and in 3% the association with the drug was thought to be definite or probable. In the remaining 3%, the relationship was uncertain. The gastrointest...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::Bilateral subconjunctival haemorrhage was observed on 5 separate occasions in 4 patients presenting a fulminant form of acute severe asthma. Four of these episodes required ventilatory support. All patients recovered from their asthma attack after treatment with bronchodilators, corticosteroids, and oxygen. The incide...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.717.579
更新日期:1985-07-01 00:00:00
abstract::A 63 year old woman had been intensively treated for recurrent carcinoma of the neck. Following acute vascular surgery of the carotid artery, she developed the vasodilatory type of the carotid sinus syndrome. The presentation of this type of the syndrome was remarkable, since it is usually associated with primary or m...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.68.800.463
更新日期:1992-06-01 00:00:00
abstract::Hypercalcaemia occurs in up to 80% of patients with adult T-cell leukaemia-lymphoma (ATLL) associated with human T-cell leukaemia virus-1 infection. Elevated serum levels of 1,25-dihydroxycholecalciferol, implicated in the pathogenesis of hypercalcaemia in lymphoma, and of parathyroid hormone-related protein (PTHrP), ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.68.803.753
更新日期:1992-09-01 00:00:00
abstract::Antenatal appendicular perforation leading to localized meconium peritonitis and intestinal obstruction is reported in a premature neonate. The baby was successfully treated by a limited ileocaecal resection. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.745.1001
更新日期:1987-11-01 00:00:00
abstract::A 29-year-old gardener developed acute renal failure following the ingestion of 'Mersil', a combination of mercurous and mercuric chloride, achieving a plasma mercury concentration of 22,000 nmol/litre (400 micrograms/litre). Haemodialysis and charcoal haemoperfusion were ineffective in removing mercury despite prior ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.60.707.636
更新日期:1984-09-01 00:00:00
abstract::The use of sulphasalazine in inflammatory bowel disease is often limited by intolerance or allergy. In previous studies 5-aminosalicylic acid (5ASA), the active ingredient of sulphasalazine, coated with an acrylic resin, has been shown to be as effective as sulphasalazine in maintaining remission. In this study coated...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.722.1047
更新日期:1985-12-01 00:00:00
abstract::A patient with chronic pancreatitis presented with a series of massive upper gastrointestinal haemorrhages due to bleeding into the pancreatic duct. This report emphasizes the value of intensive investigation before surgery, since it may be impossible to identify the site of bleeding at laparotomy. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.716.533
更新日期:1985-06-01 00:00:00
abstract::Four cases of ileo-caecal tuberculosis in Asian immigrants were seen in a 6-month period at The London Hospital. Although rare in Caucasians, this condition is an important cause of gastrointestinal symptoms in this ethnic group. Definitive diagnosis can frequently be made only by histological examination and culture ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.54.632.410
更新日期:1978-06-01 00:00:00
abstract::Defence against the reactive oxidants produced during aerobic metabolism is a complex process and is provided by a system of enzymes and antioxidant compounds capable of preventing excess radical production, neutralising free radicals and repairing the damage caused by them. Regulation of the antioxidant system must p...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.75.879.13
更新日期:1999-01-01 00:00:00
abstract::Synovial plicae are normal anatomical structures of the knee that may become symptomatic. MRI is an established technique for evaluating the anatomy of the knee, and it is a valuable tool for detecting plicae because of its high resolution resulting in increased tissue characterisation. At MRI, knee plicae appear as l...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2013-132176
更新日期:2015-01-01 00:00:00