Journal of internal medicine
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Serious complications after carotid sinus massage are rare. A case is described of monoplegia complicating carotid sinus massage in an elderly patient without symptoms or signs of cerebrovascular disease. We remind physicians of this potential complication and suggest that alternative therapies be considered prior to the use of carotid sinus massage in this age group.
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Systemic mastocytosis is a rare and chronic disorder characterized by a pathologically increased number of mast cells in various tissues and overproduction of mast cell mediators. From a group of 15 patients (10 females, 5 males) with systemic mastocytosis five female patients presented with a history of an anaphylactoid shock reaction to wasp sting. Three of them had no demonstrable specific IgE against wasp or bee venom in serum, and a skin test that was only weakly positive for wasp venom. ⋯ From the latter group two female and three male patients said they had been stung by a wasp in the past. Thus, anaphylactoid shock after Hymenoptera sting can be a presenting symptom of systemic mastocytosis and may be caused by an IgE- as well as a non-IgE-mediated mechanism. In cases of anaphylactoid reaction to Hymenoptera sting, especially when there is no IgE demonstrable in serum or in cases of intolerance of hyposensitization, the diagnosis of systemic mastocytosis should be considered, also in the absence of the clinical hallmarks of urticaria pigmentosa.
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Physical fitness and leisure time physical activity are strongly correlated, and both are inversely correlated with risk of ischaemic heart disease. Does this mean, however, that a very fit man has a lower risk of ischaemic heart disease (IHD), even if he is inactive? And does it also mean that an unfit, but active man, does not have a lower risk of IHD than an unfit, inactive man? In the Copenhagen Male Study, we analysed the joint effect of fitness and leisure time activity. In 1970/71, 4999 men aged 40-59 years, were classified according to level of physical fitness, i.e. indirectly measured maximal oxygen uptake, and physical activity, and their mortality was recorded over the following 17 years. ⋯ Adjusted for age, social class and smoking in a multiple logistic regression equation, this was estimated to an RR (95% C. I.) of 1.67 (1.06-2.64) (P = 0.027). The two major new findings of this study were (a) that being very fit, provides no protection against IHD--nor all-cause mortality--in sedentary men, and (b) that unfit but sedentary men have a higher risk of IHD than unfit but active men, i.e. those performing light physical activity for at least 4 h per week.
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Comparative Study
Evaluation of regional body fat distribution: comparison between W/H ratio and computed tomography in obese women.
Measurements of regional body fat distribution as determined by waist-to-hip ratio and visceral-to-subcutaneous adipose tissue ratio were compared in 63 obese women. Subjects were divided into three CT-evaluated tertiles on the basis of visceral-to-subcutaneous adipose tissue ratio (group I, 0.05-0.231; group II, 0.232-0.344; group III, 0.345-0.781). The three groups showed no appreciable differences in body weight, body mass index or total abdominal adipose tissue. ⋯ Partial correlations between waist-to-hip ratio and visceral-to-subcutaneous adipose tissue ratio and metabolic variables, adjusted for body mass index, showed statistically significant relationships for visceral-to-subcutaneous adipose tissue ratio, but not for waist-to-hip ratio. Visceral-to-subcutaneous adipose tissue ratio correlated with waist-to-hip ratio in the study population as a whole, but only in group I did the correlation between visceral-to-subcutaneous adipose tissue ratio and waist-to-hip ratio prove statistically significant. The present study demonstrates that visceral-to-subcutaneous adipose tissue ratio is a better index of body fat distribution than waist-to-hip ratio.