EFFECT OF PHOTOTHERAPY AND EXCHANGE TRANSFUSION ON PRIMARY BILE ACIDS IN THE SERUM OF HYPERBILIRUBINAEMIC NEWBORNS

ABSTRACT. Serum primary bile acid (cholic (CA) and chenodeoxycholic (CDCA) acid) concentrations were measured in 14 preterm and 11 full-term hyperbilirubinaemic newborns at the beginning and end of, and 24 and 72 hours following phototherapy. Only in the preterm newborns with gestational ages of 35-38 weeks there was a significant decrease of mean serum bile acid concentrations which could be shown 72 hours after the beginning of phototherapy. It can be hypothesized that the decrease was a result of a direct effect of light on the excretory liver function. Serum CA and CDCA concentrations were also measured in 5 hyperbilirubinaemic newborns at the beginning and end, and 24, 48 and 72 hours after the end of exchange transfusion. Exchange transfusion caused a clear immediate decrease in the mean serum primary bile acid concentrations. However, on day 2 after exchange transfusion the mean serum concentration of CA was about 150% and that of CDCA about 110% of the initial values. The most hyperbilirubinaemic newborns had extremely high primary bile acid serum concentrations before therapy. As bile acids compete with bilirubin for albumin binding it should be considered whether high bile acids in the serum of hyperbilirubinaemic newborns presuppose exchange transfusions.     

Stopping Insulin Treatment in Middle-aged Diabetic Patients with High Postglucagon Plasma C-Peptide

ABSTRACT We studied the successfulness of stopping insulin treatment in middle-aged diabetic patients aged 45–64 with a high postglucagon C-peptide level and the effects of this change on glycaemic control, serum lipids and lipoproteins. Insulin treatment was successfully stopped in 15 of our 22 patients who satisfied the inclusion criteria for the study and were selected on the basis of a computer file including practically all diabetic patients treated with insulin in the Kuopio University Central Hospital region (population base 250000 inhabitants). Insulin therapy was restarted in seven patients during the first 3 months after discharge. During the following 9 months insulin therapy was restarted in another three patients so that after a 1-year follow-up period half of the diabetic patients whose insulin therapy was stopped had been switched back to insulin. Insulin therapy was seldom successfully stopped if the postglucagon C-peptide value was under the limit of 1.0 nmol/l. Glycaemic control did not change during the follow-up, although there was a significant weight loss in diabetic patients. No changes were observed in serum lipids or lipoproteins with the exception of LDL cholesterol, which showed a significant reduction during the 3-month follow-up. In conclusion, insulin therapy can often be successfully stopped in patients with postglucagon C-peptide over the limit of 1.0 nmol/l without worsening of glycaemic control and without unfavourable changes in serum lipid and lipoprotein levels.     

TOLERABILITY AND EFFICACY OF A SLOW-RELEASE INDOMETHACIN TABLET IN ANKYLOSING SPONDYLITIS

The efficacy and tolerability of a new formulation of slow-releaseindomethacin tablet was compared in a double-blind cross-overmanner with a conventional indomethacin capsule in 30 patientswith ankylosing spondylitis. Gastrointestinal side-effects anddizziness were less frequent during the slow-release tabletperiod than during the capsule period. KEY WORDS: Ankylosing spondylitis, Indomethacin, Tolerability, Slow-release tablet ^*This formulation of indomethacin is not available in the UK—Ed.     

Peripheral Arterial Disease and Its Relationship to Cardiovascular Risk Factors and Coronary Heart Disease in Newly Diagnosed Non-insulin-dependent Diabetics

ABSTRACT The prevalence of peripheral arterial disease and its relationship to cardiovascular risk factors was investigated in 133 patients aged 45–64 years with newly diagnosed non-insulin-dependent diabetes and in 144 randomly selected non-diabetic subjects of the same age. History of intermittent claudication, absent foot pulses, decreased ankle-arm blood pressure ratio (<0.9) and radiologically detectable arterial calcifications of the lower limbs were used as indicators of the presence of peripheral arterial disease. Peripheral arterial disease tended to be somewhat more common in men with newly diagnosed non-insulin-dependent diabetes than in non-diabetic men, whereas no difference was found in prevalence of peripheral arterial disease between diabetic and non-diabetic women. The association of various indicators of peripheral arterial disease with cardiovascular risk factors and coronary heart disease was low or absent.     

COMPARISON OF THE ANALGESIC EFFECT OF TEN NONSTEROIDAL ANTI-INFLAMMATORY DRUGS

The analgesic effect of 10 anti-inflammatory drugs was comparedusing a single-blind method in 90 patients with rheumatoid arthritis.Each patient received two different drugs, for three days eachand each drug was evaluated in 18 patients. After the trial,the patients considered which of the drugs they preferred. The greatest relief from pain was achieved by diclofenac, indomethacin,naproxen and tolfenamic acid, each of these being preferredby the majority of patients and being significantly (p>0.01)better than the least effective drugs ketoprofen and proquazone.Acetylsalicylic acid, azapropazone, carprofen and ibuprofenwere considered intermediate in efficacy. KEY WORDS: Rheumatoid arthritis, Nonsteroidal drugs     

Examination of Infant Brain Maturation Using Ultra Low Field MRI

ABSTRACT. The brains of 42 newborn infants were examined with MRI at 0.02 T field, and regional variations of T1 relaxation time were measured from the images. There were three groups: 1. full term infants (9), 2. preterm infants (10) and 3. SGA (= small for gestational age) infants (20). Relaxation times showed a correlation to myelination of the brain. The brain of SGA infants showed a large variation in their T1 values.     

CHOLIC ACID AND CHENODEOXYCHOLIC ACID CONCENTRATIONS IN SERUM DURING INFANCY AND CHILDHOOD

Abstract. Heikura, S., Similä, S., Finni, K., Mäentausta, O. and Jänne, O. (Departments of Clinical Chemistry, Biochemistry and Paediatrics, University of Oulu, Oulu, Finland). Cholic acid and chenodeoxycholic acid concentrations in serum during infancy and childhood. Acta Paediatr Scand, 69: 659, 1980.—Concentrations of two primary bile acids (cholic and chenodeoxycholic acids) were determined by radioimmunoassay in the serum of infants and children at ages ranging from 1 hour to 15 years. The same bile acids were also measured in umbilical cord serum. Concentrations of the primary bile acids were significantly higher in the serum of 1-hour old infants than those in the umbilical cord serum or the peripheral vein serum of adults. The levels of cholic and chenodeoxycholic acid remained high until the age of 6 months, being about 5-fold higher than those in the sera of adults. Primary bile acid concentrations reached the adult level by the age of 1–2 years. These results indicate that developmental changes occur in the metabolism and excretion of bile acids in man. The relatively high concentrations of the primary bile acids in serum during the first 6 months of life suggest that up to this age, the mature ability of the liver to excrete the bile salts into the bile and/or to clear them from the circulation has not yet been reached.