No abstract

This study was carried out to investigate the clinical and biochemical factors which might be of importance in predicting the outcome of patients with myxoedema coma. Eleven patients (ten female) aged 68·1 19·5 years attended our institution over a period of 18 years.Glasgow and APACHE II scores and serum free thyroxine and TSH were measured in all the patients on entry. Patients were selected at random to be treated with two different regimens of -thyroxine.Four patients died with the mortality rate being 36·4%. The patients in coma at entry had significantly higher mortality rates than those with minor degrees of consciousness (75% vs 14·3% respectively, P=0·04). The surviving patients had significantly higher Glasgow scores than those who died (11·85 2·3 vs 5·25 2·2 respectively, P,0·001). Comparison of the mean values of APACHE II scores between the surviving group and those who died was significantly different (18·0 2·08 vs 31·5 2·08 respectively, P,0·0001).The degree of consciousness, the Glasgow score and the severity of the illness measured by APACHE II score on entry were the main factors that determined the post-treatment outcome of patients with myxoedema coma.

The incidence of and risk factors associated with hepatotoxicity in patients with chronic hepatitis have not been systematically studied. Therefore, we conducted a prospective study that included former drug users who were treated with isoniazid for latent tuberculosis infection. Of 415 patients, 20 (4.8%; 95% confidence interval [CI], 3-7.4) had hepatotoxicity diagnosed, and 6 (1.4%; 95% CI, 0.5-3.2) developed clinical hepatitis, none of whom had serious symptoms. The only 2 factors independently associated with isoniazid hepatotoxicity were excessive alcohol consumption (odds ratio [OR]; 4.2, 95% CI, 1.6-10.8; P=.002) and a high baseline alanine transaminase level (OR, 4.3; 95% CI, 1.6-11.4; P=.002). The presence of hepatitis C virus antibodies was associated with hepatotoxicity only on univariate analysis. Treatment with isoniazid in drug users appears to be safe and well tolerated, although frequent asymptomatic elevations in transaminase levels were observed.

OBJECTIVE: To determine the prevalence of overweight children and its modi®cations over a period of 10 y and whether changes in overweight prevalence is similar in the inland and coastal areas in our country. DESIGN: Cross-sectional study in two stages, the initial survey being in 1985 and the second in 1995. SUBJECTS: 1131 children (827 and 304 from coastal and inland areas respectively) in the initial survey, and 903 children (695 and 208 from coastal and inland areas) in the second survey, of both sexes, aged from 6 to 15 y were selected by a random process from the total school population in the Province of Pontevedra, North-western Spain. MEASUREMENTS: Overweight was de®ned in terms of body mass index (BMI), using Spanish standards. Children having BMI at or above the 85th percentile were classed as overweight and at or above the 95th percentile as very overweight. RESULTS: Overall prevalence of overweight and very overweight were signi®cantly higher in the second survey than in the ®rst, 18.1% vs 11.7%, P`0.05 for overweight prevalence and 6.8% vs 2.7%, P`0.05 for very overweight prevalence respectively. When we compared modi®cations in overweight prevalence over the period 10 y between the inland and coastal areas of our country, increase prevalence was observed in the inland area 9.8% vs 19.7%, P`0.05 for initial and secondary surveys respectively, whereas in the coastal area overweight prevalence remains stable, 20.2% vs 17.6%, P b 0.05. CONCLUSION: An increased prevalence of overweight children of both sexes in over a period of 10 y was observed, however, this increase was particularly caused by an increased prevalence in the inland area whereas in coastal area it remained stable. We speculate that differences in overweight prevalence between both areas might be due to differences in physical activity associated with different degrees in technological development between inland and coastal areas.