ABSTRACT
The diagnostic value of the nicotinic acid (NA)-induced hyperbilirubinaemia was compared with that resulting from caloric restriction in 40 patients with Gilbert's syndrome (GS) and 20 controls. Both tests resulted in a significant higher level of serum bilirubin in GS than in controls (P less than 0.001). When the serum bilirubin level 240 min after NA administration (5.9 mumol/kg i.v.) was higher than 18 mumoles/l, this test had a specificity and sensitivity of 100%, both in males and females with the syndrome. The discriminatory value of the test was lower when either the area under the time concentration curve or the maximal increment of serum unconjugated bilirubin were used. Reduction in caloric intake (400 calories/day) showed a lower specificity and sensitivity than the NA test, particularly in females. An increment of bilirubin at 24 h greater than 15 mumoles/l was more diagnostic than an increase by 100% or more over the pre-diet value. The efficacy was not improved by prolonging the test for additional 24 h. From these data we conclude that NA-induced hyperbilirubinaemia and, in particular the concentration of the pigment 240 min after drug administration, is more efficient than fasting-induced hyperbilirubinaemia in the diagnosis of the Gilbert's syndrome both in males and in females.
Subject(s)
Energy Intake , Hyperbilirubinemia/diagnosis , Niacin , Adult , Female , Humans , Hyperbilirubinemia/chemically induced , Male , Sex Factors , Syndrome/diagnosisABSTRACT
A system is described for the computerised storage and retrieval of information on rare dysmorphic syndromes. The clinician can ask a microcomputer for a list of syndromes with any logical combination of physical abnormalities. A descriptive title and full references are also provided on request. Similar systems would be applicable to other medical specialties.
Subject(s)
Abnormalities, Multiple/diagnosis , Diagnosis, Computer-Assisted , Diagnosis , Syndrome/diagnosis , HumansABSTRACT
The speed of flow between aortic arch and abdominal aorta was determined from the corresponding minimal transit time (MTT) measured with 113m-In-DTPA and the Fucks-Knipping gamma camera. A total of 144 individuals was examined: 62 normal persons, 34 patients with cardiac insufficiency; 31 patients with hyperkinetic syndrome (effort syndrome and hyperthyroidism) and 17 patients with isolated aortic sclerosis without impairment of cardiac function. In all individual groups there was a highly significant correlation between speed of flow and heart rate. For a given heart rate speed of flow was diminished in cases of cardiac insufficiency and aortic sclerosis; it was accelerated in patients with hyperkinetic syndrome. By plotting the speed of flow through the aorta, normalized to an arbitary heart rate, against the corresponding MTT, also normalized to the same heart rate, the presence of aortic sclerosis could be differentially recognized in 14 of the 17 patients with this disease.
